Knowledge, attitudes, and practices toward linezolid–serotonergic drug interactions: a cross-sectional study

Background Concomitant use of linezolid with serotonergic agents may lead to serotonin syndrome, a rare but serious complication. This study assessed healthcare providers’ knowledge, attitudes, and practices (KAP) to identify gaps and inform strategies to enhance patient safety. Methods We conducted a nationwide, cross-sectional survey among physicians, pharmacists, and nurses practicing in Saudi Arabia. Participants completed a validated questionnaire designed to assess KAP related to linezolid–serotonergic drug interactions. KAP scores were categorized and analyzed using logistic regression to identify predictors associated with higher performance. Results Among 116 respondents, 69.0% reported awareness of linezolid–serotonergic drug interaction. However, only 30.2% achieved high knowledge scores (≥6.7/10). Correct identification of serotonin syndrome, Hunter diagnostic criteria, and the recommended 2-week washout period was limited (34.5%, 34.5%, and 41.4%, respectively). Pharmacists had the highest knowledge scores (mean 5.52), followed by physicians (5.18) and nurses (2.79). In multivariable analysis, prior awareness of the interaction (AOR, 23.52; 95% CI, 2.90–190.72) and international training (AOR, 3.51; 95% CI, 1.07–11.53) were associated with higher knowledge scores. Both knowledge and attitude were significantly associated with safer practice behaviors (OR 3.04 and 8.75, respectively; p < 0.05). Conclusion Persistent gaps in knowledge and safe prescribing practices related to the linezolid–serotonergic interaction were identified among healthcare providers in Saudi Arabia, reflecting a broader challenge globally. These findings support the need for targeted educational interventions and institution-level policies to improve awareness, enhance patient safety, and reduce preventable harm.