Objective: To observe the efficacy and safety of linezolid in the treatment of bacterial meningitis in children. Methods: Retrospective analysis was performed on the clinical data of children diagnosed with meningitis meningitis who had failed first-line antibiotic treatment and received linezolid in Wuhan Children’s Hospital from Dec. 2012 to Dec. 2017. Results: A total of 29 cases were included

with a median age of 4 months

and 14 cases (48.3%) with precursor infection of pneumonia. Convulsions were found in 19 cases (65.5%)

and 17 cases (58.6%) had neurological complications

mainly complicated by subdural effusion. Bacterial culture of cerebrospinal fluid was positive in 12 cases (41.4%)

including 5 cases of Streptococcus pneumoniae

6 cases of Streptococcus agalactiae and 1 case of Staphylococcus aureus. Of the 29 cases

4 cases were cured

22 cases were improved

2 cases were improved

and 1 case was not improved

and the total effective rate was 89.7%. The mean valley concentration of linezolid in the blood and cerebrospinal fluid of two children were respectively 1.8 μg/mL and 1.2 μg/mL

and the cerebrospinal fluid penetration rate was 66.7%. After anti-infection treatment

the hypersensitive C protein

procalcitonin

white blood cell count and protein levels were lower than those before treatment (P<0.05)

and the cerebrospinal fluid glucose recovered significantly (P<0.05). No obvious adverse drug reactions were observed during the treatment. Conclusion: For confirmed or suspected bacterial meningitis infected by gram-positive bacteria infection

if the first-line drug treatment fails

linezolid can be used as the second-line drug treatment for children with bacterial meningitis

with reliable efficacy and higher safety.