Go to content

Defining the Risk and Risk Factors for Serotonin Syndrome Associated with Linezolid use: A Retrospective Cohort Study

Project ID: 2021-925 / TRIM 2023 0970 304 000

Principle Investigator: Anthony Bai

Description: Linezolid is a relatively new antibiotic approved by Canada in 2001. It is a synthetic oxazolidinone that has excellent activity against resistant gram-positive bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). Its bioavailability approaches 100%, making it ideal as step-down oral antibiotic therapy for bacteremia, pneumonia as well as skin and soft tissue infections. However, its use has been limited due to potential drug interactions. Linezolid can reversibly inhibit monoamine oxidase (MAO). Co-administration with anti-depressants such as non-selective MAO inhibitors, selective serotonin re-uptake inhibitors (SSRI), serotonin–norepinephrine reuptake inhibitor (SNRI) and bupropion can precipitate serotonin syndrome. Anti-depressants are commonly prescribed for patients, so many patients who needed linezolid for an infection could not receive it due to this relative contraindication. However, the data on the risk of serotonin syndrome associated with linezolid has been scarce.

PIA Approved: April 5, 2022