Optimizing Linezolid Dosing by Renal Function: A Population Pharmacokinetic Study.

Objectives: Linezolid is administered at a fixed dose of 600 mg twice daily for the treatment of Gram‐positive infections. However, recent population pharmacokinetic studies reveal considerable interpatient variability, resulting in subtherapeutic or supratherapeutic drug exposures. This study aimed...

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Published in:Journal of Clinical Pharmacy & Therapeutics Vol. 2026; pp. 1 - 10
Main Authors: Ha, Khue N. Y., Tran, Ngan T. K., Nguyen, Cuc T., Nguyen, Thu T. A., Vu, Nhi T. L., Nguyen, Truc T. T., Vo, Cam T. N., Lu, Vy T., Do, Quan D., Duong, Diem N., Bui, Khanh H. T., Vu, Hoa D., Dang-Nguyen, Doan-Trang, Bondareva, Irina B.
Format: equations & formulas research tables/charts Journal Article
Published: Wiley-Blackwell 3/24/2026
Online Access:View this record in EBSCOhost
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      dt: 3/24/2026
      vid: 2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Optimizing Linezolid Dosing by Renal Function: A Population Pharmacokinetic Study.
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          Ha, Khue N. Y.
          Tran, Ngan T. K.
          Nguyen, Cuc T.
          Nguyen, Thu T. A.
          Vu, Nhi T. L.
          Nguyen, Truc T. T.
          Vo, Cam T. N.
          Lu, Vy T.
          Do, Quan D.
          Duong, Diem N.
          Bui, Khanh H. T.
          Vu, Hoa D.
          Dang-Nguyen, Doan-Trang
          Bondareva, Irina B.
        affil: School of Pharmacy,, University of Medicine and Pharmacy at Ho Chi Minh City,, Ho Chi Minh, Vietnam, hcmut.edu.vn
      sug:
        subj:
          Gram-Positive Bacterial Infections Drug Therapy
          Cross Infection Drug Therapy
          Linezolid Pharmacokinetics
          Linezolid Administration and Dosage
          Linezolid Therapeutic Use
          Kidney Physiology
          Hospitalization
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Prospective Studies
          Vietnam
          Inpatients
          Administration, Intravenous
          Confidence Intervals
          Descriptive Statistics
          ROC Curve
          Drug Monitoring
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Objectives: Linezolid is administered at a fixed dose of 600 mg twice daily for the treatment of Gram‐positive infections. However, recent population pharmacokinetic studies reveal considerable interpatient variability, resulting in subtherapeutic or supratherapeutic drug exposures. This study aimed to describe the pharmacokinetics of linezolid in hospitalized infectious patients across varying degrees of renal function and propose optimized dosing strategies. Methods: Population pharmacokinetic modeling was performed using Monolix Version 2024R1. The model was evaluated using goodness‐of‐fit plots, bootstrap analysis, and prediction‐corrected visual predictive checks. Appropriate dosing regimens for different levels of renal function and minimum inhibitory concentrations were proposed by Monte Carlo simulations. Results: Fifty‐five adult patients with a total of 178 linezolid concentration measurements were included. A two‐compartment model with first‐order absorption and linear elimination best described the pharmacokinetic data. Volume of distribution and clearances were scaled using an allometric weight model. In addition, creatinine clearance (CLcr) significantly affected linezolid clearance. Simulation results suggested that patients with CLcr ≤ 30 mL/min may require reduced doses (600–900 mg daily), whereas those with CLcr ≥ 110 mL/min may benefit from increased doses (600 mg every 8 h). Conclusions: Individualization of linezolid dosing based on renal function is warranted. Therapeutic drug monitoring is recommended for patients with impaired or augmented renal clearance to optimize the therapeutic efficacy and minimize the risk of toxicity.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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