Linezolid versus vancomycin for Staphylococcus aureus bacteraemia: Pooled analysis of randomized studies

Andrew F. Shorr, Mark J. Kunkel, Marin Kollef

Research output: Contribution to journalArticlepeer-review

158 Scopus citations

Abstract

Objectives: To compare outcomes in patients with Staphylococcusaureus bacteraemia treated with linezolid with those of vancomycin-treated patients. Methods: We pooled and analysed five randomized studies comparing linezolid with vancomycin, focusing on the 144 adults with S. aureus bacteraemia, which was secondary in >70% of patients. Efficacy variables were clinical cure of primary infection, microbiological success (eradication of S. aureus from blood or presumed eradication based on clinical cure of primary infection), survival, and outcome predictors identified by multivariate logistic regression. Results: Of 99 clinically evaluable patients, primary infection was cured in 28 (55%) of 51 linezolid recipients and 25 (52%) of 48 vancomycin recipients [odds ratio (OR) for cure with linezolid versus vancomycin, 1.12; 95% confidence interval (CI), 0.51-2.47]. There were no between-group differences in the meta-analysis (OR, 1.16; 95% CI, 0.5-2.65). Of 53 evaluable patients with methicillin-resistant S. aureus (MRSA) bacteraemia, clinical cure occurred in 14 (56%) of 25 linezolid recipients and 13 (46%) of 28 vancomycin recipients (OR, 1.47; 95% CI, 0.50-4.34). Microbiological success occurred in 41 (69%) of 59 linezolid recipients and 41 (73%) of 56 vancomycin recipients (OR, 0.83; 95% CI, 0.37-1.87). Fifty-five (74%) of 74 linezolid recipients survived versus 52 (74%) of 70 vancomycin recipients (OR, 1.00; 95% CI, 0.47-2.12). In the multivariate analysis, treatment group was not a significant predictor of clinical cure or survival. Conclusions: Linezolid was associated with outcomes that were not inferior to those of vancomycin in patients with secondary S. aureus bacteraemia.

Original languageEnglish
Pages (from-to)923-929
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume56
Issue number5
DOIs
StatePublished - Nov 2005

Keywords

  • Methicillin-resistant Staphylococcus aureus
  • Survival
  • Thrombocytopenia

Fingerprint

Dive into the research topics of 'Linezolid versus vancomycin for Staphylococcus aureus bacteraemia: Pooled analysis of randomized studies'. Together they form a unique fingerprint.

Cite this