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JAC Advance Access published online on October 13, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki368
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received August 9, 2005
Revised September 2, 2005
Accepted September 15, 2005

Brief report

Linezolid-associated serotonin syndrome: what we can learn from cases reported so far

José Antonio Morales-Molina 1, Javier Mateu-de Antonio 1, Mónica Marín-Casino 1, and Santiago Grau 1*

1 Pharmacy Department, Hospital del Mar, Passeig Marítim, 25-29, 08003 Barcelona, Spain

* To whom correspondence should be addressed.
Santiago Grau, E-mail: sgrau{at}imas.imim.es


  Abstract

Objectives: To study the characteristics of the linezolid-associated serotonin syndrome cases.

Methods: Database search for linezolid-associated serotonin syndrome.

Results: Twelve cases were found. The mean age of patients was 52.8 years. All patients received linezolid concomitantly with selective serotonin re-uptake inhibitor drugs (SSRID). The onset of syndrome was 9.5 days after linezolid introduction and was directly correlated to patients' age (P = 0.024). The symptoms resolved in 2.9 days. Citalopram was associated with a delayed resolution (P = 0.018). A trend was observed towards longer resolution time the longer the half-life of the interacting drug (P = 0.096).

Conclusions: Patients are at risk when receiving SSRID concomitant with linezolid. The syndrome onset could be delayed in older patients. The resolution could be delayed when citalopram is involved in the syndrome.

Keywords: citalopram; oxazolidinones; serotonin uptake inhibitors.
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