Q: 56 year old male with ESRD is admitted to ICU with VRE pneumonia and sepsis.  Due to hemodynamic compromise, initially patient was put on CRRT. Patient responded well to Linezolid and is now switched to regular hemodialysis (HD). What care should be taken to maintain efficacy of Linezolid?

Answer:  Administer linezolid after HD session.

HD removes 30–40% of a dose of Linezolid so it should be given after HD session on the day of dialysis.  In CRRT no adjustment is needed but every 8 hours administration instead of every 12 hours of total daily dose is advisable.