In Vitro Susceptibility Testing of Tedizolid against Isolates of Nocardia

There is a paucity of efficacious antimicrobials (especially oral) against clinically relevant species of Nocardia . To date, all species of Nocardia have been susceptible to linezolid, the first commercially available oxazolidinone. Tedizolid is a new oxazolidinone with previously reported improved in vitro and in vivo (intracellular) potency against multidrug-resistant strains of Mycobacterium sp. and Nocardia brasiliensis . Using the current Clinical and Laboratory Standards Institute-recommended broth microdilution method, 101 isolates of Nocardia spp., including 29 Nocardia cyriacigeorgica , 17 Nocardia farcinica , 13 Nocardia nova complex, 21 Nocardia brasiliensis , 5 Nocardia pseudobrasiliensis , and 5 Nocardia wallacei isolates and 11 isolates of less common species, were tested for susceptibility to tedizolid and linezolid. For the most common clinically significant species of Nocardia , tedizolid MIC 50 values were 0.25 μg/ml for N. nova complex, N. brasiliensis , N. pseudobrasiliensis , and N. wallacei , compared to linezolid MIC 50 values of 1, 2, 0.5, and 1 μg/ml, respectively. Tedizolid and linezolid MIC 90 values were 2 μg/ml for N. nova complex and N. brasiliensis . Tedizolid MIC 50 and MIC 90 values for both N. cyriacigeorgica and N. farcinica were 0.5 μg/ml and 1 μg/ml, respectively, compared to linezolid MIC 50 and MIC 90 values of 2 and 4 μg/ml, respectively. Based on MIC 90 values, this study showed that tedizolid was 2- to 3-fold more active than linezolid in vitro against most common species of Nocardia , with the exception of the N. nova complex and N. brasiliensis , for which values were the same. These results may warrant evaluation of tedizolid as a potential treatment option for Nocardia infections.