To investigate the curative effect and security of the Linezolid on severe pneumonia in elderly.

Three cases of male advanced aged severe pneumonia (all are hospital acquired pneumonia) from Zhongnan Hospital of Wuhan university during January 2015 to January 2016 were selected. They were first treated with the third generation cephalosporins/β-lactamase inhibitor combined with carbapenems broad-spectrum antibiotics combined with teicoplanin intravenous infusion for initial empirical treatment, and sputum bacterial culture were obtained. If ineffective, antibiotics were changed into linezolid (600 mg intravenous infusion, 2 times/d) instead of teicoplanin continued treatment according to sputum bacterial culture results. Clinical manifestations, imaging features, efficacy and adverse reactions before and after linezolid treatment, were analysis.

All patients are accompanied by liver and renal dysfunction but normal platelet. Empirical therapy resulted invalid after five days treatment. Sputum samples are respectively isolated resistant staphylococcus aureus, escherichia coli + pseudomonas aeruginosa and acinetobacter baumannii+ resistant staphylococcus aureus. After switched to linezolid 600 mg ivgtt bid for 7 days, the liver function returned to normal, renal dysfunction return to better, imaging features showed pulmonary lesions absorbed. During the treatment, two patients' platelet decline on the fifth days, but returned to normal three days after drug withdrawal.

In elderly patients of severe pneumonia with aspiration history, the pathogenic bacterium is mainly a mixture infection of gram negative bacilli, anaerobic bacteria and methicillin-resistant staphylococcus aureus. If empirical teicoplanin combining with other antibiotics is not effective, staphylococcus aureus resistant to glycopeptide antibiotics should be considered. Then use linezolid to replace teicoplanin can obviously improve the cure rate of severe pneumonia and prognosis as well as its higher security.