Linezolid is an oxazolidone antibiotic mainly used to treat specific Gram positive bacterial infections. Its use should strictly follow the indications and pay attention to risks such as bone marrow suppression and drug interactions. The following provides a detailed explanation from two aspects: classification of indications and key precautions.

1. Scope of indications

(1) Complex skin and soft tissue infections: including diabetes foot infection, necrotizing fasciitis, etc. caused by Staphylococcus aureus, Streptococcus pyogenes, etc.

(2) Hospital acquired pneumonia: applicable to pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) or penicillin insensitive Streptococcus pneumoniae.

(3) Community acquired pneumonia: limited to cases clearly caused by penicillin insensitive Streptococcus pneumoniae.

(4) Vancomycin resistant Enterococcus (VRE) infection: second-line treatment for severe infections including bacteremia.

2. Medication precautions

(1) Bone marrow suppression monitoring: Blood routine should be checked weekly after more than 2 weeks of treatment, and the necessity of continuing medication should be evaluated when thrombocytopenia or anemia occurs.

(2) Prevention of 5-hydroxytryptamine syndrome: Do not use in combination with SSRI/SNRI antidepressants, tramadol, etc. If tremors or high fever occur during medication, stop immediately.

(3) Dietary restrictions: Avoid consuming foods with high levels of casein (such as aged cheese and fermented foods) to prevent sudden increases in blood pressure.

(4) Special population medication: Use only during pregnancy when the benefits outweigh the drawbacks, and suspend feeding during lactation; Children need to adjust the dosage, and those with renal insufficiency do not need to reduce it.

(5) Course control: Continuous medication should not exceed 28 days to avoid the risk of irreversible peripheral neuropathy and optic nerve damage.

(6) Drug resistance management: Strictly limit the use to drug-resistant bacterial infections and avoid using it as a first-line drug to delay the development of drug resistance.