Objectives

Linezolid is a commonly used antibiotic in the clinical treatment of gram-positive bacterial infections. The impacts of drug interactions on the pharmacokinetics of linezolid are often overlooked. This manuscript aims to review the medications that affect the pharmacokinetics of linezolid.

Methods

In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we queried the PubMed, Embase, and Cochrane Library for publications from database establishment to November 3, 2023, using the search terms: “Linezolid” and “interaction,” or “interact,” or “drug-drug interaction,” or “co-treatment,” or “cotreatment,” or “combined,” or “combination.”

Results

A total of 24 articles were included. Among the reported medication interactions, rifampicin, levothyroxine, venlafaxine, and phenobarbital could reduce the concentration of linezolid; clarithromycin, digoxin, cyclosporine, proton pump inhibitors, and amiodarone could increase the concentration of linezolid, while aztreonam, phenylpropanolamine, dextromethorphan, antioxidant vitamins, and magnesium-containing antacids had no significant effects on linezolid pharmacokinetics. The ratio of mean (ROM) of linezolid AUC in co-treatment with rifampicin to monotherapy was 0.67 (95%CI 0.58–0.77) and 0.63 (95%CI 0.43–0.91), respectively, in 2 studies, and co-treatment with 500 mg clarithromycin to monotherapy was 1.81 (95%CI 1.49–2.13).

Conclusions

This systematic review found that numerous drugs have an impact on the pharmacokinetics of linezolid, and the purported main mechanism may be that linezolid is the substrate of P-glycoprotein. In clinical practice, it is prudent to pay attention to the changes in linezolid pharmacokinetics caused by interactions. Conducting therapeutic drug monitoring (TDM) is beneficial to improve efficacy and reduce adverse reactions of linezolid.

中文翻译：

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药物相互作用对利奈唑胺药代动力学的影响：系统评价

目标

利奈唑胺是临床治疗革兰氏阳性菌感染常用的抗生素。药物相互作用对利奈唑胺药代动力学的影响常常被忽视。本手稿旨在回顾影响利奈唑胺药代动力学的药物。

方法

根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，我们使用搜索词“利奈唑胺”和“相互作用”查询了 PubMed、Embase 和 Cochrane 图书馆从数据库建立到 2023 年 11 月 3 日期间的出版物。 ”、“相互作用”、“药物-药物相互作用”、“联合治疗”、“联合治疗”、“联合治疗”、“联合治疗”。

结果

共收录文章24篇。在已报告的药物相互作用中，利福平、左旋甲状腺素、文拉法辛和苯巴比妥可降低利奈唑胺的浓度；克拉霉素、地高辛、环孢素、质子泵抑制剂和胺碘酮可增加利奈唑胺的浓度，而氨曲南、苯丙醇胺、右美沙芬、抗氧化维生素和含镁抗酸剂对利奈唑胺的药代动力学无显着影响。在 2 项研究中，利福平联合治疗与单药治疗的利奈唑胺 AUC 平均值 (ROM) 之比分别为 0.67 (95% CI 0.58–0.77) 和 0.63 (95% CI 0.43–0.91)。 500 mg 克拉霉素与单药治疗的比值为 1.81 (95% CI 1.49–2.13)。

结论

本系统综述发现，许多药物对利奈唑胺的药代动力学有影响，据称主要机制可能是利奈唑胺是P-糖蛋白的底物。在临床实践中，应谨慎关注相互作用引起的利奈唑胺药代动力学的变化。进行治疗药物监测（TDM）有利于提高利奈唑胺疗效、减少不良反应。