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利奈唑胺为恶唑烷酮类抗生素,主要用于耐万古霉素的肠球菌和耐甲氧西林金黄色葡萄球菌感染的治疗。患者应用利奈唑胺后1～16周可发生血乳酸水平升高,甚至导致乳酸酸中毒。临床表现为恶心、呕吐、腹泻、心动过速,甚至意识模糊。利奈唑胺诱导乳酸酸中毒的机制可能与抑制线粒体蛋白质合成有关。防治措施如下:应用利奈唑胺时应监测血乳酸水平;一旦乳酸水平超过正常值应立即停药;严重乳酸酸中毒患者应予对症治疗;利奈唑胺应避免与5-羟色胺再摄取抑制剂合用。
Linezolid is an oxazolidinone antibiotic, mainly used for the treatment of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus infections. Patients with linezolid after 1 to 16 weeks can occur elevated blood lactate levels, and even lead to lactic acidosis. Clinical manifestations of nausea, vomiting, diarrhea, tachycardia, and even confusion. Linezolid induction of lactic acidosis may be related to inhibition of mitochondrial protein synthesis. Prevention and treatment measures are as follows: linezolid should be used to monitor blood lactate levels; once the level of lactic acid than normal should be discontinued immediately; severe lactic acidosis patients should be symptomatic treatment; linezolid should avoid combined with serotonin reuptake inhibitors .