SpringerLink
Log in

Use of oxazolidinones (linezolid or tedizolid) for the treatment of breast infections. A case series from a tertiary referral hospital

  • Brief Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Objectives

Mastitis is mainly caused by Gram-positive bacteria and usually involves treatment with beta-lactam antibiotics and clindamycin. Oxazolidinones show good results in the treatment of skin and soft tissue infections (SSTIs) due to its pharmacokinetic characteristics. We aimed to describe clinical characteristics and outcomes of patients who received oxazolidinones for the treatment of SSTIs of the mammary tissue.

Methods

Retrospective single-centre study of patients with a diagnosis of breast infection who received treatment with oxazolidinones as initial or salvage therapy between September 2016 and November 2022. Patients were identified through the pharmacy database. The primary outcome was clinical cure.

Results

Twenty-nine patients received oxazolidinones: 27 received linezolid and 2 tedizolid. Median age was 41 years (IQR 31.0–56.5) and 28 patients were female. Ten patients (35%) had a history of breast cancer, while three (10%) had an immunosuppressive condition. Microbiological isolation was obtained in 24 individuals (83%). Predominant isolations were methicillin-resistant Staphylococcus aureus (8, 28%) and methicillin-susceptible S. aureus (7, 24%). Twenty-four patients (83%) received oxazolidinones as a salvage therapy, with a median duration of 14 days (IQR 10–17). Clinical cure was achieved in 24 patients (83%), while 4 relapsed after a median of 15 days (IQR 4–34). One was lost to follow-up. Three patients (10%) were taking selective serotonin reuptake inhibitors, and one of them concurrently received linezolid for 4 days with no adverse events recorded. Cytopenia during treatment was observed in 2/12 individuals. Oxazolidinones allowed hospital discharge in 11/13 hospitalized patients.

Conclusions

Oxazolidinones could be considered as an alternative for treating breast infections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Anonymized data supporting the current study’s findings are available for any qualified investigator upon reasonable request to the corresponding author.

References

  1. Contreras GA, Rodriguez JM. Mastitis: comparative etiology and epidemiology. J Mammary Gland Biol Neoplasia. 2011;16:339–56. https://doi.org/10.1007/s10911-011-9234-0.

    Article  PubMed  Google Scholar 

  2. Kvist LJ, Larsson BW, Hall-Lord ML, Steen A, Schalen C. The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment. Int Breastfeed J. 2008;3:6. https://doi.org/10.1186/1746-4358-3-6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Louis-Jacques AF, Berwick M, Mitchell KB. Risk factors, symptoms, and treatment of lactational mastitis. JAMA. 2023;329:588–9. https://doi.org/10.1001/jama.2023.0004.

    Article  PubMed  Google Scholar 

  4. Righi E, Carnelutti A, Bassetti M. Current role of oxazolidinones and lipoglycopeptides in skin and soft tissue infections. Curr Opin Infect Dis. 2019;32:123–9. https://doi.org/10.1097/QCO.0000000000000529.

    Article  PubMed  Google Scholar 

  5. Crotty MP, Krekel T, Burnham CA, Ritchie DJ. New gram-positive agents: the next generation of oxazolidinones and lipoglycopeptides. J Clin Microbiol. 2016;54:2225–32. https://doi.org/10.1128/JCM.03395-15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rowe HE, Felkins K, Cooper SD, Hale TW. Transfer of linezolid into breast milk. J Hum Lact. 2014;30:410–2. https://doi.org/10.1177/0890334414546045.

    Article  PubMed  Google Scholar 

  7. Linezolid. BMNIoCHaHD-. Drugs and Lactation Database (LactMed®) [Internet]. 2020 [Available from: https://www.ncbi.nlm.nih.gov/books/NBK501700/. Accessed 12 Dec 2023.

  8. (FDA) UFaDA. SIVEXTRO 2019 [Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/205436s005lbl.pdf. Accessed 12 Dec 2023.

  9. (FDA) UFaDA. ZYVOX 2013 [Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021130s032,021131s026,021132s031lbl.pdf. Accessed 12 Dec 2023.

  10. Stevens DL, Smith LG, Bruss JB, McConnell-Martin MA, Duvall SE, Todd WM, et al. Randomized comparison of linezolid (PNU-100766) versus oxacillin-dicloxacillin for treatment of complicated skin and soft tissue infections. Antimicrob Agents Chemother. 2000;44:3408–13. https://doi.org/10.1128/AAC.44.12.3408-3413.2000.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Yue J, Dong BR, Yang M, Chen X, Wu T, Liu GJ. Linezolid versus vancomycin for skin and soft tissue infections. Cochrane Database Syst Rev. 2016;2016:CD008056. https://doi.org/10.1002/14651858.CD008056.pub3.

    Article  PubMed  PubMed Central  Google Scholar 

  12. McKinnon PS, Sorensen SV, Liu LZ, Itani KM. Impact of linezolid on economic outcomes and determinants of cost in a clinical trial evaluating patients with MRSA complicated skin and soft-tissue infections. Ann Pharmacother. 2006;40:1017–23. https://doi.org/10.1345/aph.1G728.

    Article  PubMed  Google Scholar 

  13. Vazquez JA, Arnold AC, Swanson RN, Biswas P, Bassetti M. Safety of long-term use of linezolid: results of an open-label study. Ther Clin Risk Manag. 2016;12:1347–54. https://doi.org/10.2147/TCRM.S109444.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Lv X, Alder J, Li L, O’Riordan W, Rybak MJ, Ye H, et al. Efficacy and safety of tedizolid phosphate versus linezolid in a randomized phase 3 trial in patients with acute bacterial skin and skin structure infection. Antimicrob Agents Chemother. 2019. https://doi.org/10.1128/AAC.02252-18.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Elbarbry F, Moshirian N. Linezolid-associated serotonin toxicity: a systematic review. Eur J Clin Pharmacol. 2023;79:875–83. https://doi.org/10.1007/s00228-023-03500-9.

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Servei de Malalties Infeccioses, Hospital Universitari Vall d’Hebron, Barcelona, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Campus Hospitalari. Passeig de la Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Cristina Kirkegaard & Nuria Fernández-Hidalgo

  2. Pharmacy Service, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Campus Hospitalari. Passeig de la Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Carlos Javier Parramón-Teixidó & Susana Clemente Bautista

  3. Department of Breast Surgical Oncology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Campus Hospitalari, Passeig de la Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Clara Morales-Comas & Joaquín Rivero Deniz

  4. Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

    Nuria Fernández-Hidalgo

  5. CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain

    Nuria Fernández-Hidalgo

Authors
  1. Cristina Kirkegaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlos Javier Parramón-Teixidó
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Clara Morales-Comas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susana Clemente Bautista
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joaquín Rivero Deniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nuria Fernández-Hidalgo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CK and NFH: contributed to the conception and design of the study. CJPT, CMC, SCB and JRD: contributed to the acquisition and analysis of data and provided statistical advice on the study. CK: drafted the manuscript and prepared the figures and tables with significant contributions from CJPT, CMC, SCB, JRD and NFH. All authors reviewed and edited the earlier draft of this article and approved the final version of the same.

Corresponding author

Correspondence to Nuria Fernández-Hidalgo.

Ethics declarations

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Vall d’Hebron Research Institute Ethics Committee [registration code EOM(AG)030/2023(6143)].

Consent to participate

Need for informed consent was waived, as data and samples were analysed retrospectively, and the study was non-interventional in nature.

Consent to publish

Not applicable.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kirkegaard, C., Parramón-Teixidó, C.J., Morales-Comas, C. et al. Use of oxazolidinones (linezolid or tedizolid) for the treatment of breast infections. A case series from a tertiary referral hospital. Infection (2024). https://doi.org/10.1007/s15010-024-02269-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s15010-024-02269-y

Keywords

Search

Navigation