Abstract
Background:
Linezolid (LNZ) is a broad-spectrum antibiotic commonly used to treat bacterial infections but is associated with adverse hepatic effects, including myelosuppression and hepatotoxicity.

Aim:
This study aims to explore the biochemical and histopathological changes induced by LNZ in the liver of male albino rats and to evaluate the protective role of vitamin E and Echinacea purpurea (immulant) combined with LNZ treatment.

Methods:
Forty-nine male Spraque–Dawley rats were divided equally into seven groups: a control (DW, 0.5 ml /200g/day), Tween 80 (0.5 ml /200g/day), LNZ (54 mg/kg b.wt), Vit E (90 mg/kg b.wt), immulant (15.75 mg/kg b.wt), Vit E+ LNZ, and immulant+ LNZ treated groups.

Results:
After 14 days post-treatments, the LNZ-treated group exhibited significant reduction in the hematological profile and significant changes in serum levels of liver enzymes, bilirubin, proteins and lipid profiles, as well as foci of hepatocellular apoptotic cells, shrunken nuclei and hydropic degeneration and apoptotic (Caspase-3) expression in liver by histopathological immunohistochemical means of investigation. However, Vit E or immulant treatment in combination with LZN markedly reduced these adverse effects, indicating a protective effect of Vit E and immulant.

Conclusion:
This study concludes that Vit E or immulant provide a protective effect against LNZ -induced hepatic toxicity, suggesting that concurrent antioxidant therapy may help safeguard the liver during LNZ treatment.

Key words: Linezolid; Vitamin E; Liver enzymes; Echinacea purpurea.