Linezolid for treatment of subdural empyema due to Streptococcus: case reports

Background: Recurring subdural empyema despite adequate surgical drainage and antibiotic treatment is still a life-threatening disease. This is mainly due to poor diffusion of the antibiotic into the subdural space. Case Description: We report 2 cases of recurring subdural empyema due to Streptococcus. after repeat surgery and high-dose antibiotic treatment including beta-lactamines and vancomycin. Both patients showed marked clinical and radiologic improvement after introduction of linezolid. There was no drug-related adverse effect despite 36 and 90 days of treatment. Conclusion: Off-label use of linezolid for treatment Of subdural empyema due to gram-positive bacteria should be considered after failure of conventional antibiotic treatment. (C) 2009 Elsevier Inc. All rights reserved.