Safety of Linezolid Administration in Patients Receiving Serotonergic Medications
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Publication Date
2025
Abstract
Background: Linezolid is an oxazolidinone antibiotic with activity against gram positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA). However, the use of linezolid has been limited due to concerns for drug interactions and the risk of precipitating serotonin syndrome. There is a growing body of retrospective evidence that suggests that the risk of serotonin syndrome in patients receiving linezolid and serotonergic agents is extremely rare. This study will assess the incidence of serotonin syndrome in hospitalized patients receiving linezolid with or without a concomitant serotonergic agent. Methods: This is a multicenter, retrospective cohort study of patients hospitalized at one of the eight hospitals within Providence St Joseph Health System in Oregon between January to October 2023. Patients were included if they were at least 18 years of age and received linezolid during a hospital admission. The comparator groups were patients receiving linezolid monotherapy and patients receiving at least one dose of a serotonergic agent within 24 hours of linezolid administration. The primary outcome was the incidence of serotonin syndrome. The secondary outcome will be in-hospital mortality. The presence of serotonin syndrome was determined by physician-diagnosed serotonin syndrome or was considered a likely diagnosis of serotonin syndrome using the Hunter criteria and Sternbach criteria. Electronic medical records were searched for terms related to the presence of serotonin syndrome including serotonin syndrome, clonus, myoclonus, tremor, hyperreflexia, hypertonic, agitation, shivering, incoordination, fever, diaphoresis, incoordination, and all results related to serotonin. Results: Research in progress, data analysis will be finalized in April 2024 (IRB approved).
Specialty/Research Institute
Graduate Medical Education
