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Linezolid and vancomycin for nosocomial infections in pediatric patients: a systematic review
Bruno Russo Porchera1, Carolina Moraes da Silva1, Rayssa Pinheiro Miranda1
1Centro Universitário do Estado do Pará (CESUPA), Curso de Medicina, Belém, PA, Brazil.
Insights
Linezolid and vancomycin effectively treat pediatric nosocomial infections. Linezolid demonstrates superior safety, with fewer adverse reactions like rash, making it a promising option for resistant Gram-positive bacterial infections in children.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Therapy
- Clinical Pharmacology
Background:
- Nosocomial infections pose a significant threat to hospitalized children.
- Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), are common pathogens.
- Effective treatment options are crucial for managing these infections.
Conclusions:
- Linezolid and vancomycin are effective treatments for nosocomial Gram-positive bacterial infections in children.
- Linezolid offers a favorable safety profile compared to vancomycin.
- Further clinical trials are recommended to solidify these findings.
Objective:
To investigate the effectiveness of linezolid and vancomycin for the treatment of nosocomial infections in children under 12 years old.
Data Sources:
This is a systematic review in which five randomized clinical trials about the effectiveness of linezolid and vancomycin, involving a total of 429 children with nosocomial infections, were evaluated. They were searched in scientific databases: PubMed, Bvs, and SciELO.
Summary Of Findings:
The main nosocomial infections that affected children were bacteremia, skin, and soft tissue infections followed by nosocomial pneumonia. Most infections were caused by Gram-positive bacteria, which all studies showed infections caused by Staphylococcus aureus, with methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci strains being isolated. Both linezolid and vancomycin showed high therapeutic efficacy against different types of nosocomial infections, ranging from 84.4% to 94% for linezolid and 76.9% to 90% for vancomycin. Patients receiving linezolid had lower rates of rash and red man syndrome compared to those receiving vancomycin. However, despite the adverse reactions, antimicrobials can be safely administered to children to treat nosocomial infections caused by resistant Gram-positive bacteria.
Conclusion:
Both linezolid and vancomycin showed good efficacy in the treatment of bacterial infections caused by resistant Gram-positive bacteria in hospitalized children. However, linezolid stands out regarding its pharmacological safety. Importantly, to strengthen this conclusion, further clinical trials are needed to provide additional evidence.
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