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2002, Número 2

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Enf Infec Microbiol 2002; 22 (2)


Las aplicaciones clínicas de la farmacodinámica y farmacocinética de linezolid

Morfín OR, Esparza AS, Rodríguez NE

Idioma: Español
Referencias bibliográficas: 50
Paginas: 69-74
Archivo PDF: 64.15 Kb.


RESUMEN

Antecedentes. La resistencia en bacterias grampositivas se ha ido incrementando en los últimos años. Las bacterias resistentes como Staphylococcus aureus, Streptococcus pneumoniae y Enterococcus patógenos frecuentes en infecciones comunitarias y nosocomiales. El tratamiento de las infecciones por grampositivos resistentes se complica por la resistencia a meticilina/oxacilina en S. aureus, a penicilinas en S. pneumoniae y a vancomicina en Enterococos. Objetivo. Revisar las propiedades farmacocinéticas y farmacodinámicas de linezolid. Fuentes de información. Búsqueda en Medline de estudios relacionados con la farmacocinética y farmacodinámica de linezolid. Selección de estudios. Se revisaron cincuenta estudios. Resultados. Linezolid es un nuevo agente antimicrobiano que pertenece a la familia de las oxazolidinonas. Linezolid es un inhibidor de síntesis proteica. Linezolid es activo contra una variedad de bacterias grampositivas sensibles y resistentes. Después de la administración de 600 mg la vida media es de 5.5 horas en la fase de eliminación, las concentraciones máximas promedio en plasma son de 15 a 21 μg/mL. La biodisponibilidad después de su administración oral es del 100%, con un tiempo para concentración máxima por esta vía de administración de 1.0 a 1.5 horas. Linezolid tiene una buena penetración tisular incluyendo piel y sus estructuras y el tejido pulmonar. La dosis usual de linezolid en adultos es de 600 mg cada 12 horas y en pediatría la dosis usual será muy probablemente de 10 mg/kilo cada 8 horas. El éxito terapéutico de linezolid está relacionado directamente con una concentración superior a las concentraciones inhibitorias mínimas, que excedan el 39% del tiempo entre dosis. La absorción rápida después de la administración oral facilitará altas tempranas de pacientes con infecciones severas. Conclusiones. Las características farmacocinéticas, farmacodinámicas y de farmacoeconomía son bases para el uso de linezolid en el tratamiento de infecciones por bacterias grampositivas resistente.


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