Multidrug resistance has now become a major issue in the treatment of serious infections. Data on treatment of infections due to multidrug-resistant pathogens are limited, especially for the transplant population. We describe a patient with methicillin- resistant Staphylococcus aureus (MRSA) infection of a recently transplanted renal allograft who was treated successfully with linezolid (an oxazolidinone; U-100766, Pharmacia Upjohn, Kalamazoo, MI). The pharmacology and method of action of this drug are also briefly reviewed. A 25-year-old man with end-stage renal disease secondary to Wegner's granulomatosis had a history of intra-abdominal abscess and sepsis due to both vancomycin-resistant enterococcus (VRE) and MRSA in 1997 that were successfully treated with quinopristin/dalfopristin (Rhône-Poulenc Rorer, Collegeville, PA). There was no evidence of residual infection in the 14-month follow-up period. In 1998, the patient received a cadaveric transplant. Ten days after the operation, he developed fever, malaise, and right lower quadrant pain at the site of the transplanted kidney. The WBC count was 20,000/mm3 with 16% band forms. An ultrasonogram revealed extravasation of urine around the kidney.
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Antony et al. (1999) studied this question.
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