Table 1.
Studies comparing linezolid with vancomycin or teicoplanin
| Ref | Intervention | Participants | Outcomes | Results |
| Linezolid v vancomycin for MRSA infection of any body site | ||||
| [13] | Linezolid (600 mg every 12 hours iv or orally for 7–21 days) v vancomycin (1 g every 12 hours iv for 7–21 days) | 756 adults with MRSA infection | Proportion of people with clinical cure | 301/379 (79%) with linezolid v 252/377 (67%) with vancomycin; OR 2.48, 95% CI 1.68 to 3.64 |
| 756 adults with MRSA infection | Proportion of people with bacterial clearance (time frames not reported) | 262/337 (78%) with linezolid v 195/328 (59%) with vancomycin; OR 2.68, 95% CI 1.29 to 5.57); however, there was significant statistical heterogeneity for this outcome (P = 0.005; heterogeneity defined as P = 0.10). The review included a diverse group of clinical infections and ages and healthcare settings, which may have contributed to this heterogeneity | ||
| [14] | Linezolid (600 mg iv every 12 hours for 7–21 days) v vancomycin (0.75–1 g iv every 12 hours for 7–21 days) | 144 people with known or suspected infection with gram-positive bacteria randomised, 131 people available for this analysis | Proportion of people with clinically effective treatment at 72 hours post treatment | 53/61 (87%) with linezolid v 37/70 (62%) with vancomycin; 95% CI for the difference in rates 10.3 to 40.2; P = 0.0015 |
| 144 people with known or suspected infection with gram-positive bacteria randomised, 116 people available for this analysis | Proportion of people with clinically effective treatment at 7 to 28 days post treatment. Data for MRSA infection not reported | 49/59 (83%) with linezolid v 37/57 (65%) with vancomycin; 95% CI for the difference in rates 2.5 to 33.8; P = 0.03 | ||
| Linezolid v vancomycin for MRSA nosocomial pneumonia | ||||
| [13] | Linezolid (600 mg every 12 hours iv or orally for 7–21 days) v vancomycin (1 g every 12 hours iv for 7–21 days | Subgroup analysis of adults with MRSA nosocomial pneumonia (number of RCTs and people in this analysis not reported) | Proportion of people with clinical cure | OR 3.45, 95% CI 1.90 to 6.26; favours linezolid; absolute results per group not reported |
| Subgroup analysis of adults with MRSA nosocomial pneumonia (number of RCTs and people in this analysis not reported) | Proportion of people with bacterial clearance (time frames not reported) | OR 2.60, 95% CI 1.31 to 5.15; favours linezolid; absolute results per group not reported | ||
| [14] | Linezolid (600 mg iv every 12 hours for 7–21 days) v vancomycin (0.75–1 g iv every 12 hours for 7–21 days) | Subgroup analysis of 62 people with known or suspected infection with gram-positive pneumonia | Proportion of people with clinically effective treatment at 72 hours post treatment | Data for MRSA infection not reported. 22/28 (79%) with linezolid v 18/34 (53%) with vancomycin; 95% CI for the difference in rates 2.99 to 48.3 |
| Subgroup analysis of 59 people with known or suspected infection with gram-positive pneumonia | Proportion of people with clinically effective treatment at 7 to 28 days post treatment | Data for MRSA infection not reported. 19/26 (73%) with linezolid v 18/33 (55%) with vancomycin; 95% CI for the difference in rates –5.5 to +42.6 | ||
| Linezolid v vancomycin for MRSA skin and soft-tissue infection | ||||
| [13] | Linezolid (600 mg every 12 hours iv or orally for 7–21 days) v vancomycin (1 g every 12 hours iv for 7–21 days) | Subgroup analysis of adults with MRSA skin and soft-tissue infection (number of RCTs and people in this analysis not reported) | Proportion of people with clinical cure (time frame not reported) | OR 2.84, 95% CI 1.47 to 5.49; favours linezolid; absolute results per group not reported |
| Subgroup analysis of adults with MRSA skin and soft-tissue infection (number of RCTs and people in this analysis not reported) | Proportion of people with bacterial clearance (time frame not reported) | OR 4.56, 95% CI 2.65 to 7.83; favours linezolid; absolute results per group not reported | ||
| [14] | Linezolid (600 mg iv every 12 hours for 7–21 days) v vancomycin (0.75–1 g iv every 12 hours for 7–21 days) | Subgroup analysis of 59 people with known or suspected complicated skin or soft-tissue infection with gram-positive bacteria | Proportion of people with clinically effective treatment at 72 hours post treatment | Data for MRSA infection not reported. 31/33 (94%) with linezolid v 19/26 (73%) with vancomycin; 95% CI for the difference in rates 1.97 to 39.8 |
| Subgroup analysis of 57 people with known or suspected complicated skin or soft-tissue infection with gram-positive bacteria | Proportion of people with clinically effective treatment at 7 to 28 days post treatment | Data for MRSA infection not reported. 30/33 (91%) with linezolid v 19/24 (79%) with vancomycin; 95% CI for the difference in rates –7.2 to +30.7 | ||
| Linezolid v vancomycin for MRSA bacteraemia | ||||
| [15] | Linezolid v vancomycin | 144 people with secondary S aureus bacteraemia, subgroup analysis in 73/144 (51%) people with MRSA | Survival for MRSA bacteraemia | 24/36 (67%) with linezolid v 24/37 (65%) with vancomycin; OR 1.08, 95% CI 0.41 to 2.85 |
| [16] | Linezolid (10 mg/kg to 600 mg iv every 8–12 hours) v vancomycin (10 mg to 1 g iv every 6–24 hours) | 7 RCTs, subgroup analysis in adults and children with MRSA bacteraemia | Proportion of people with clinical cure (time frame not reported) | 65/92 (71%) with linezolid v 41/68 (60%) with vancomycin; RR 1.22, 95% CI 0.97 to 1.53; P = 0.10 |
| Linezolid v teicoplanin for MRSA infection of any body site | ||||
| [17] | Linezolid (600 mg every 12 hours) v teicoplanin (400 mg every 12 hours for 3 doses, then 400 mg every 24 hours iv) | 202 people with suspected or confirmed gram-positive infections in an intensive care population; 82 people had confirmed MRSA | Clinical cure rate | Data for MRSA infection not reported. For all people: 71/90 (79%) with linezolid v 67/92 (73%) with teicoplanin; P = 0.39; RR 1.10, 95% CI 0.92 to 1.27 |
| 202 people with suspected or proved gram-positive infections in an intensive care population; 82 people had proved MRSA | Mortality | Data for MRSA infection not reported. For all people: 18% with linezolid v 25% with teicoplanin; P = 0.3 | ||
iv, intravenous; ref, reference.