Optimizing Tedizolid Dosing in Cerebral Nocardiosis: Clinical Impact of Direct Unbound Concentration Measurement and Population PK Modelling in Two Cases

These cases highlight moderate CSF penetration of tedizolid and substantial interpatient variability in protein binding. Direct measurement of unbound concentrations was critical for accurate PK/PD assessment. Although higher dosing may improve central nervous system (CNS) exposure and outcomes, tedizolid should not be considered interchangeable with linezolid for CNS nocardiosis. Individualized monitoring of free plasma levels may help optimize dosing strategies.