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Linezolid continuous infusion increases clinical cure rates and pharmacodynamic target attainment compared to intermittent infusionContinuous infusion of linezolid shows higher rates of clinical cure

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Key Takeaway
Consider continuous infusion for linezolid to improve clinical cure rates and pharmacodynamic target attainment.

This meta-analysis evaluated the efficacy of continuous infusion (CI) versus intermittent infusion (II) for patients receiving linezolid. The analysis included a total sample size of 389 patients to compare these two dosing strategies for clinical outcomes and pharmacodynamic targets.

The primary finding was that the CI group achieved higher rates of clinical cure compared to the II group (RR=1.33, 95% CI: 1.14-1.54, P<0.05). Additionally, the CI group showed significantly higher rates of reaching the pharmacodynamic target of AUC/MIC > 80 compared to the II group (RR=1.91, 95% CI: 1.13-3.24, P=0.02). Mortality rates showed no significant difference between the CI and II groups.

Authors noted that it is uncertain whether the higher rates of pharmacodynamic target attainment in the CI group translated into improved patient outcomes. The study aims to provide evidence for optimizing linezolid dosing. Clinical application should consider these findings as an association rather than a confirmed causal link to improved survival.

How this fits prior evidence

This meta-analysis extends the evidence regarding linezolid administration. It builds upon previous findings that linezolid-containing regimens are associated with higher peripheral neuropathy risk despite improved clinical outcomes. While the prior coverage established the clinical utility of linezolid, this study specifically addresses the optimization of dosing methods, showing that continuous infusion improves pharmacodynamic target attainment and clinical cure rates compared to intermittent infusion.

When doctors treat serious infections, the way they deliver medicine matters. This study looked at how patients responded to linezolid, an antibiotic, when it was given as a continuous infusion versus a standard intermittent infusion.

Researchers found that patients receiving the continuous infusion had higher rates of clinical cure. They also saw higher rates of reaching a specific drug target called AUC/MIC. This target is a way to measure if the drug is staying in the body at a high enough level to fight the infection effectively.

While the continuous method showed better results in these specific areas, the study did not find a significant difference in mortality rates between the two methods. It is still unclear if hitting those higher drug targets translates into better overall outcomes for the patients. Because the evidence is still being weighed, talk to your doctor about the best dosing method for your specific needs.

What this means for you:
Continuous infusion of linezolid shows higher clinical cure rates and better drug target attainment.

Common questions

What is the difference between continuous and intermittent infusion?

Continuous infusion means the medicine, like linezolid, is given steadily over a period of time. Intermittent infusion means the medicine is given in separate doses at specific intervals. This study found that the continuous method led to higher rates of clinical cure and better attainment of the AUC/MIC target.

Does continuous infusion of linezolid improve survival rates?

The study looked at mortality, which is the death rate, and found no significant difference between the continuous and intermittent infusion methods. While the continuous method showed better clinical cure rates, it did not show a different impact on mortality.

What is the AUC/MIC target mentioned in the study?

AUC/MIC is a way to measure if the drug concentration in the body is high enough to be effective against an infection. The study found that patients receiving a continuous infusion had higher rates of reaching this target compared to those receiving intermittent doses.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
ObjectiveWe aimed to compare the clinical cure profile of linezolid administered as continuous infusion (CI) vs. intermittent infusion (II), to provide practicable evidence for optimizing linezolid dosing.MethodA systematic search of major electronic databases (PubMed, Cochrane Library, Web of Science, and Embase) was performed to identify randomized controlled trials (RCTs) that compared continuous versus intermittent infusion linezolid regimens, covering the period from database inception to 2026 April. After literature screening and data abstraction, the methodological quality of the eligible RCTs was appraised using the ROB-2 tool, and meta-analysis along with sensitivity analyses were performed via RevMan 5.4.ResultFinally, 389 patients from 5 RCTs were finally analyzed. Meta-analysis demonstrated that compared with the II group, the CI group had substantially higher rates of both AUC/MIC > 80 attainment (RR = 1.91, 95% CI: 1.13–3.24, P = 0.02) and clinical cure (RR = 1.33, 95% CI: 1.14–1.54, P  80) and higher clinical cure rate. However, no significant difference in mortality was observed between continuous and intermittent infusion. Therefore, whether better PK/PD target attainment translated into better patient outcomes remained uncertain. Given these findings, larger-scale, multi-center RCTs focusing on linezolid dosing strategies are urgently warranted to corroborate these observations.
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