Table 1.
Summary of some trials of linezolid for pneumonia caused by MRSA and VRE infections
| Study | Type of study | Results |
|---|---|---|
| Peyrani et al81 | Prospective observational trial for VAP due to MRSA | Clinical success occurred in 85% of linezolid-treated patients compared with 69% of vancomycin-treated patients (p=0.009) |
| Jiang et al82 | Meta-analysis of nosocomial pneumonia | Evaluation of 12 RCTs showed that although linezolid was more effective in microbiological eradication than glycopeptide antibiotics for nosocomial pneumonia patients, it did not represent superiority in clinical cure |
| Awad et al83 | RCT for nosocomial pneumonia including VAP | Cure rates in nosocomial pneumonia (excluding VAP) patients for ceftobiprole vs ceftazidime and linezolid were 59.6% vs 58.8% and 77.8% vs 76.2%. Cure rates in VAP patients were 23.1% vs 36.8% and 37.7% vs 55.9% |
| Wang et al84 | Systematic review employing meta-analysis on suspected MRSA nosocomial pneumonia | Evaluation of nine RCTs found linezolid was not superior to vancomycin for clinical cure |
| Whang et al85 | Systematic review and meta-analysis on VRE-BSIs | There were limited data to inform clinicians on optimal antibiotic selection (linezolid vs daptomycin) for VRE-BSIs. Available studies were limited by small sample size, lack of patient-level data, and inconsistent outcome definitions |
| Balli et al86 | Systematic review and meta-analysis on VRE bacteremia | Ten retrospective studies comparing daptomycin to linezolid treatment for VRE bacteremia were identified. Patients treated with daptomycin had significantly higher 30-day all-cause mortality (OR, 1.61; 95% CI, 1.08–2.40) and infection-related mortality (OR, 3.61; 95% CI, 1.42–9.20) rates than patients treated with linezolid |
| Chuang et al87 | Systematic review and meta-analysis on VRE bacteremia | Although limited data were available, the meta-analysis showed that linezolid treatment for VRE bacteremia was associated with a lower mortality than daptomycin treatment |
| Britt et al88 | Retrospective cohort on VRE-BSIs | Treatment with linezolid for VRE-BSIs resulted in significantly higher treatment failure in comparison to daptomycin. Linezolid treatment was also associated with greater 30-day all-cause mortality and microbiological failure in this cohort |
| Crank et al89 | Retrospective cohort on VRE-BSIs | There were no significant differences in mortality of VRE-BSIs between patients receiving daptomycin or linezolid |
| Erlandson et al90 | Retrospective review on VRE-BSIs | Univariate analysis indicated significantly more deaths in the quinupristin-dalfopristin group (OR, 5.45; 95% CI, 1.89–15.9) and in the other-agents group (OR, 2.94; 95% CI, 1.09–7.94) than in the linezolid group |
Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; VRE, vancomycin-resistant enterococci; VAP, ventilator-associated pneumonia; RCT, randomized controlled trial; BSI, blood stream infection; OR, odds ratio.