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Linezolid versus vancomycin for the treatment of infections caused by methicillin-resistant Staphylococcus aureus in

S Kohno1, K Yamaguchi, N Aikawa

  • 1Second Department of Internal Medicine, Nagasaki University Graduate School of Pharmaceutical Sciences, Nagasaki, Japan.

The Journal of Antimicrobial Chemotherapy
|October 5, 2007
PubMed
Abstract

Insights

Linezolid and vancomycin show similar efficacy for treating methicillin-resistant Staphylococcus aureus (MRSA) infections. Linezolid may offer superior microbiological eradication, though it is associated with more frequent, reversible hematologic side effects like thrombocytopenia.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
  • Effective antibiotic treatment options for MRSA infections are crucial.

Purpose of the Study:

  • To compare the clinical efficacy and safety of linezolid versus vancomycin for MRSA infections in Japan.
  • To evaluate microbiological eradication rates and adverse events associated with both antibiotics.

Main Methods:

  • A randomized study involving patients with MRSA nosocomial pneumonia, complicated skin and soft-tissue infections, or sepsis.
  • Patients received either linezolid (600 mg every 12 hours) or vancomycin (1 g every 12 hours).
  • Outcomes were assessed at the end of therapy and during a 7-14 day follow-up period.

Main Results:

  • Clinical success rates at end of therapy were 62.9% for linezolid and 50.0% for vancomycin.
  • Microbiological eradication rates were significantly higher with linezolid (79.0%) compared to vancomycin (30.0%) at end of therapy (P < 0.0001).
  • Linezolid was associated with more frequent reversible anemia and thrombocytopenia, although severe thrombocytopenia was more common with vancomycin.

Conclusions:

  • Linezolid demonstrates comparable efficacy to vancomycin in treating MRSA infections.
  • Linezolid may be more effective in achieving microbiological eradication.
  • Hematological adverse events, particularly mild reversible thrombocytopenia, were more frequent with linezolid.

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