ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
This article is part of the Research TopicPharmacist and patient safety: Focus on drug safetyView all 14 articles
Knowledge, Attitudes, and Practices Toward Linezolid– Serotonergic Drug Interactions: A Cross-Sectional Study
Provisionally accepted
Atheer O. Aldairem1,2,3*
Shuroug Alowais1,2,3
Sumaya N Almohareb1,2,4
Mohammad Shawaqfeh1,2Abdullah A Alzahrani1Abdullah Y. Alzahrani1Khalid Alqahtani1Khalid A Bin Saleh1,2,3- 1Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- 3Department of Pharmaceutical Care, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
- 4Department of Pharmacy Pharmaceutical Care, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
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Abstract 1.1 Background Concomitant use of linezolid with serotonergic agents may lead to serotonin syndrome, a rare but serious complication. This study assessed healthcare providers' knowledge, attitudes, and practices (KAP) to identify gaps and inform strategies to enhance patient safety. 1.2 Methods We conducted a nationwide, cross-sectional survey among physicians, pharmacists, and nurses practicing in Saudi Arabia. Participants completed a validated questionnaire designed to assess KAP related to linezolid–serotonergic drug interactions. KAP scores were categorized and analyzed using logistic regression to identify predictors associated with higher performance. 1.3 Results Among 116 respondents, 69.0% reported awareness of linezolid–serotonergic drug interaction. However, only 30.2% achieved high knowledge scores (≥6.7/10). Correct identification of serotonin syndrome, Hunter diagnostic criteria, and the recommended 2-week washout period was limited (34.5%, 34.5%, and 41.4%, respectively). Pharmacists had the highest knowledge scores (mean 5.52), followed by physicians (5.18) and nurses (2.79). In multivariable analysis, prior awareness of the interaction (AOR, 23.52; 95% CI, 2.90–190.72) and international training (AOR, 3.51; 95% CI, 1.07–11.53) were associated with higher knowledge scores. Both knowledge and attitude were significantly associated with safer practice behaviors (OR 3.04 and 8.75, respectively; p<0.05). 1.4 Conclusions Persistent gaps in knowledge and safe prescribing practices related to the linezolid– serotonergic interaction were identified among healthcare providers in Saudi Arabia, reflecting a broader challenge globally. These findings support the need for targeted educational interventions and institution-level policies to improve awareness, enhance patient safety, and reduce preventable harm.
Keywords: linezolid, Serotonergic drugs, Serotonin Syndrome, Patient Safety, Drug-Drug Interaction
Received: 09 Oct 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Aldairem, Alowais, Almohareb, Shawaqfeh, Alzahrani, Alzahrani, Alqahtani and Bin Saleh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Atheer O. Aldairem, atheerothman@gmail.com
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