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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 3, Pages 177-182
http://dx.doi.org/10.1155/2006/818535
Original Articles

An Assessment of Linezolid Utilization in Selected Canadian Provinces

Sandra Walker,1,2,3 Linda Dresser,3,4 Debbie Becker,5 and Alissa Scalera6

1Department of Pharmacy, Division of Clinical Pharmacology, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Canada
2Department of Medicine, Division of Clinical Pharmacology, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Canada
3Faculty of Pharmacy, University of Toronto, Canada
4Department of Pharmacy, Mount Sinai Hospital, Toronto, Canada
5i3 Innovus, Burlington, Ontario, Canada
6Pfizer Canada Inc, Kirkland, Quebec, Canada

Received 11 April 2005; Accepted 6 April 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Linezolid is approved for the treatment of designated infections caused by methicillin-resistant and -susceptible Staphylococcus aureus and vancomycin-resistant Enterococcus faecium.

OBJECTIVE: To characterize linezolid utilization since its launch in Canada in 2001.

METHODS: Demographics, antimicrobial regimens, and clinical and resource utilization data for linezolid-treated patients were collected retrospectively by hospital pharmacists at nine tertiary care hospitals in four provinces. Statistics describing linezolid utilization were calculated and the appropriateness of use was assessed according to a treatment algorithm based on recommendations of the Infectious Diseases Pharmacy Specialty Network in 2001.

RESULTS: Ninety-nine linezolid courses were prescribed for 103 infections in 95 patients (mean age 57.8 years, 52.6% male) with an average length of hospital stay of 40.6 days. Fifty-three per cent of patients had an allergy to at least one antibiotic other than linezolid. The major use of linezolid was for treatment of skin and soft tissue infections (32.0%), followed by bacteremia (15.5%). The most prevalent pathogen was methicillin-resistant S aureus, identified in 44.7% of infections. Linezolid was primarily prescribed as the oral form following other intravenous anti-infectives (55.6% of courses) for an average duration of 14.4 days. The rate of appropriate utilization was 53% (range 25% to 75% by site). In 93.5% of courses deemed inappropriate, recommended first-line therapies were not attempted before linezolid.

CONCLUSIONS: Linezolid was prescribed appropriately in approximately one-half of cases reviewed. The rate of appropriate utilization is similar to those rates reported in other Canadian antibiotic reviews.