Background: Linezolid has been found to have considerable interindividual variability, especially in critically ill patients, which can lead to suboptimal plasma concentration. To overcome this shortcoming, several solutions have been proposed. These include using loading dose, higher maintenance doses, and dose stratification according to the patient’s particularities, therapeutic drug monitoring, and drug administration via continuous infusion (CI) instead of intermittent infusion (II). In the present study, we aim to compare the pharmacokinetic (PK) parameters of linezolid after administration as II versus CI to critically ill patients. Methods: In a prospective study conducted in an intensive care unit, we compared the same two daily doses of linezolid administered via II versus CI. The serum concentration was measured, and pharmacokinetic parameters were calculated. The pharmacokinetic/pharmacodynamic (PK/PD) indices for efficacy chosen were area under the concentration–time curve at steady state divided by the minimum inhibitory concentration over 80 (AUC24–48/MIC > 80). Results: Greater serum concentration variability was observed in the II group than in the CI group. The %T > MIC > 80% was achieved for MICs of 1 and 2 µg/mL 100% of the time, whereas for the II group, this was 93% and 73%, respectively. AUC24–48/MIC > 80 was reached in 100% of cases in the CI group compared with 87% in the II group for a MIC of 1 µg/mL. Conclusions: The two infusion methods may be used comparably, but utilizing CI as an alternative to II may have potential benefits, including avoiding periods of suboptimal concentrations, which may enhance safety profiles and clinical outcomes. Considering the relatively few studies performed on linezolid to date, which are increasing in number, the results of the present study may be of interest.

Introduction: Linezolid is a reserve antibiotic used to treat infections caused by Gram-positive bacteria with resistance genes. In critically ill patients, high intra- and interindividual variability has been observed, prompting the search for alternative methods to reduce this variability and achieve the pharmacokinetic/pharmacodynamic indices necessary for a favorable efficacy–safety balance. Aim of the study: We wished to compare the safety and effectiveness of a continuous infusion (CI) versus an intermittent infusion (II) of linezolid in patients requiring intensive care. Materials and Methods: This study, registered under the number NCT05801484), was a prospective, open-label, single-center, two-arm study. Data on hematologic safety and effectiveness were collected and compared between patients receiving CI and II, respectively, at the same daily dose of linezolid (1200 mg). Results: Twenty-nine patients from the intensive care unit were included, divided into two groups. No statistically significant difference was found in 30-day mortality between the groups, nor in the likelihood of post-treatment culture negativity. However, a significantly greater reduction in C-reactive protein levels was observed in the CI group compared to the II group. Regarding safety, at CrCl < 60 mL/min, the decrease in platelets was statistically significant in group II but not in group CI. Additionally, at the 30-day follow-up, recovery from thrombocytopenia was better in the CI group. Conclusions: Continuous infusion of linezolid proved to be non-inferior to intermittent infusion at the same daily dose in terms of effectiveness. Furthermore, a lower risk of adverse reactions was identified with continuous infusion.

Background/Objectives: Sarcopenia is a progressive decline in skeletal muscle strength and mass, leading to decreased functionality, metabolic disorders, morbidity, and mortality. There are a number of sarcopenia screening tools, such as the SARC-F questionnaire (that includes noting strength, assistance with walking, ability to raise from the chair, climb stairs, and falls), with its augmented forms that have added calf circumference (SARC-CalF), BMI and age (SARC-F + EBM), and the Ishii score, which show variable performance across populations. However, these were developed and validated mostly in Asian cohorts. To evaluate the diagnostic accuracy of these tools for the European Working Group on Sarcopenia in Older People (EWGSOP2), as well as define sarcopenia in hospitalized East European older adults, with sex and obesity stratification. Methods: Sarcopenia was diagnosed using the EWGSOP2. ROC analyses with DeLong tests assessed SARC-F, SARC-CalF, SARC-F + EBM, and the Ishii score in 278 Romanian inpatients (probable sarcopenia n = 201/278, 72.3%; confirmed n = 77/278, 27.7%). Results: Probable sarcopenia was noted as good-excellent discrimination against across all tools (AUCs 0.764–0.812); confirmed sarcopenia was noted as SARC-CalF superior (AUC = 0.743), followed by SARC-F + EBM (0.697), the Ishii score as moderate (0.667), and SARC-F was limited (0.591; p < 0.001 vs. augmented). SARC-CalF optimal cut-offs varied significantly: 4–6 (probable) vs. ≥11 (confirmed). Sex-stratified outcomes had excellent probable detection in both sexes, and this was confirmed to be superior in men. The Ishii score thresholds were 152/244 vs. Asian ≥ 105/120. Obesity required higher cut-offs with high NPVs (77–100%), confirming rule-out utility and SARC-F + EBM performing the best, both in the obesity and sarcopenic obesity subgroups (AUCs 0.742, 0.964). Conclusions: Augmented SARC-F scores outperformed the original SARC-F for confirmed sarcopenia in multimorbid Europeans, with SARC-F CalF having the best performance overall. Population-specific (sex/obesity) data-driven thresholds are essential, especially for the Ishii score, as this first Romanian validation reveals limitations of Asian norms in European cohorts, thus advocating for European recalibration.

Background/Objectives: Vitamin D is essential for calcium and phosphorus homeostasis and bone mineralization in infancy; serum 25-hydroxyvitamin D [25(OH)D] is its main biomarker. In Romania, data on vitamin D status among infants younger than six months remain limited, despite evidence of suboptimal status in other Romanian pediatric and perinatal populations. This study aimed to assess vitamin D status in infants aged 1–5 months in northwestern Romania and its associations with supplementation dose, feeding type, and season of blood sampling. Methods: This single-center observational study included infants aged 1–5 months. Serum 25(OH)D was interpreted as deficient (<12 ng/mL), insufficient (12–100 ng/mL). Statistical analyses used parametric or non-parametric methods as appropriate to data distribution. Results: The cohort included 124 girls (56.6%) and 95 boys (43.4%; median age 4 [3–5] months). Median serum 25(OH)D was 61.24 [49.53–75.32] ng/mL; 94.5% of infants had sufficient concentrations, deficiency and insufficiency each occurred in 0.9%, and 3.7% had potentially excessive concentrations. Serum 25(OH)D increased progressively with reported supplementation dose (p < 0.0001) and differed by feeding type (p = 0.0279), with breastfed infants having higher concentrations than formula-fed infants. No significant seasonal difference was observed (p = 0.4218). Conclusions: In this hospital-based cohort, most infants had sufficient 25(OH)D concentrations, in a context of near-universal supplementation. Higher reported doses were associated with higher 25(OH)D concentrations, and concentrations >100 ng/mL occurred almost exclusively in infants receiving 2000 IU/day. Without data on calcium metabolism, these concentrations do not indicate vitamin D toxicity, but they support adherence to recommended prophylactic doses.