Editing Linezolid (section)

===Pneumonia===
No significant difference appears in treatment success rates between linezolid, glycopeptides, or appropriate beta-lactam antibiotics in the treatment of pneumonia.<ref name=Falagas2008/> [[Medical guideline|Clinical guideline]]s for the treatment of community-acquired pneumonia developed by the [[American Thoracic Society]] and the [[Infectious Diseases Society of America]] recommend that linezolid be reserved for cases in which MRSA has been confirmed as the causative organism, or when MRSA infection is suspected based on the clinical presentation.<ref name=USCAPGuidelines>{{cite journal  |vauthors=Mandell LA, Wunderink RG, Anzueto A, etal |title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults |journal=Clinical Infectious Diseases |volume=44 |issue=Suppl 2 |pages=S27–72 |date=March 2007 |pmid=17278083 |doi=10.1086/511159 |pmc=7107997 |issn=1058-4838|doi-access=free }}</ref> The guidelines of the [[British Thoracic Society]] do not recommend it as first-line treatment, but rather as an alternative to vancomycin.<ref name=BTSCAPGuidelines>{{cite web|url=http://www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Pneumonia/Guidelines/MACAPrevisedApr04.pdf |title=BTS guidelines for the management of community acquired pneumonia in adults&nbsp;– 2004 update |author=BTS Pneumonia Guidelines Committee |publisher=[[British Thoracic Society]] |date=30 April 2004 |access-date=30 June 2009 |url-status=dead |archive-url=https://web.archive.org/web/20090407092653/http://www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Pneumonia/Guidelines/MACAPrevisedApr04.pdf |archive-date=7 April 2009 }}</ref> Linezolid is also an acceptable second-line treatment for community-acquired pneumococcal pneumonia when penicillin resistance is present.<ref name=USCAPGuidelines/>

U.S. guidelines recommend either linezolid or vancomycin as the first-line treatment for hospital-acquired (nosocomial) MRSA pneumonia.<ref name=USHAPGuideline>{{cite journal |author=American Thoracic Society |author-link=American Thoracic Society |author2 = Infectious Diseases Society |author-link2 = Infectious Diseases Society of America |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=American Journal of Respiratory and Critical Care Medicine |volume=171 |issue=4 |pages=388–416 |date=February 2005 |pmid=15699079 |doi=10.1164/rccm.200405-644ST  |s2cid=14907563 }}</ref> Some studies have suggested that linezolid is better than vancomycin against nosocomial pneumonia, particularly [[ventilator-associated pneumonia]] caused by MRSA, perhaps because the penetration of linezolid into bronchial fluids is much higher than that of vancomycin. Several issues in study design have been raised, however, calling into question results that suggest the superiority of linezolid.<ref name=Pigrau/> Regardless, linezolid's advantages include its high [[oral bioavailability]]—which allows easy switching to oral therapy—and the fact that poor kidney function is not an obstacle to use.<ref name=USHAPGuideline/> In contrast, achieving the correct dosage of vancomycin in patients with [[kidney failure]] is very difficult.<ref name=USHAPGuideline/>