Clinical and economic outcomes of oral linezolid versus intravenous vancomycin in the treatment of MRSA-complicated, lower-extremity skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus

Sharpe, J. Neal; Shively, Eugene H.; Polk, Hiram C.

doi:10.1016/j.amjsurg.2005.01.011

Cited by 156 publications

(109 citation statements)

References 6 publications

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“…Vancomycin was compared with linezolid in 14 trials, [25][26][27][28][29][30][31][32][33][34][35][36][37][38] [74][75][76] and iclaprim in 1. 77 In trials studying febrile neutropenic patients, vancomycin and comparator antibiotics were included in the first-line empirical regimen in 7 trials, 32,54,61,62,64,67,69 in 2 trials they were administered after treatment failure of the initial regimen (usually a ␤-lactam with or without an aminoglycoside) was encountered, 59,71 and in the remaining 3 randomization was performed after the VANCOMYCIN FOR GRAM-POSITIVE INFECTIONS: A META-ANALYSIS isolation of gram-positive cocci.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of Randomized Controlled Trials of Vancomycin for the Treatment of Patients With Gram-Positive Infections: Focus on the Study Design

Vardakas

Mavros

Roussos

et al. 2012

Mayo Clinic Proceedings

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Objective: To study the effectiveness and safety of vancomycin compared with that of other antibiotics for the treatment of gram-positive infections. Methods: Major electronic databases were searched. Data from published randomized controlled trials (January 1, 1950, to September 15, 2011 were pooled using a meta-analytic method. Results: Fifty-three trials comparing vancomycin with linezolid, daptomycin, quinupristin-dalfopristin, tigecycline, ceftaroline, ceftobiprole, telavancin, teicoplanin, iclaprim, and dalbavancin were included in the meta-analysis. Individual antibiotics were as effective as vancomycin, except for linezolid, which was more effective than vancomycin for the treatment of skin and soft tissue infections (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.07-2.43). Comparators were as effective as vancomycin in the intent-to-treat population (OR, 1.08; 95% CI, 0.98-1.18) but were more effective in the clinically evaluable population (OR, 1.14; 95% CI, 1.02-1.27) when all infections were pooled. When available data from all trials were pooled, no differences were noted when patients with febrile neutropenia (OR, 1.07; 95% CI, 0.82-1.39), pneumonia (OR, 1.10; 95% CI, 0.87-1.37), bacteremia (OR, 1.05; 95% CI, 0.76-1.45), and skin and soft tissue infections (OR, 1.11; 95% CI, 0.89-1.39) were studied. Comparators were more effective in open-label (OR, 1.28; 95% CI, 1.08-1.50) but not in double-blind trials (OR, 1.04; 95% CI, 0.90-1.20). Total adverse events attributed to studied antibiotics (OR, 1.07; 95% CI, 0.90-1.28) and patients withdrawn from trials (OR, 0.86; 95% CI, 0.68-1.09) were similar in the compared groups. Mortality was not different between vancomycin and comparator antibiotics when all trials were included in the analysis (OR, 1.09; 95% CI, 0.96-1.23). Comparators were associated with higher mortality in open-label (OR, 1.27; 95% CI, 1.05-1.54) but not double-blind trials (OR, 0.96; 95% CI, 0.80-1.14). Conclusion: On the basis mainly of data from open-label trials, vancomycin is a treatment choice that is as effective as other available antibiotics for patients with gram-positive infections. Study design seems to make a major contribution to the outcome.

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Section: Resultsmentioning

confidence: 99%

Meta-analysis of Randomized Controlled Trials of Vancomycin for the Treatment of Patients With Gram-Positive Infections: Focus on the Study Design

Vardakas

Mavros

Roussos

et al. 2012

Mayo Clinic Proceedings

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“…While length of stay was generally lower (1.0 to 3.5 days) for patients treated with linezolid compared to vancomycin in randomized controlled trials, it was uncertain whether these decreases would be experienced in clinical practice, particularly due to the small efficacy trial sample sizes and MRSA subgroup analyses (7,15,18,19,30). In our pharmacoepidemiologic effectiveness study of patients hospitalized with MRSA infections in VA facilities throughout the country, the median length of stay was 3 days shorter among those treated with linezolid compared to those treated with vancomycin.…”

Section: Discussionmentioning

confidence: 99%

“…In subgroup analyses, we assessed variations by infection type (24). We evaluated various follow-up periods for all-cause readmission (30,60,180, and 365 days) in sensitivity analyses. All analyses were performed using SAS software (version 9.1; SAS Institute Inc., Cary, NC).…”

Section: Methodsmentioning

confidence: 99%

“…Linezolid, an oxazolidinone antibiotic, was approved by the Food and Drug Administration in April 2000. While a limited number of clinical trials have reported linezolid superiority, many have found efficacy equivalent to that of vancomycin for the treatment of MRSA infections (10,14,30,31,33,(35)(36)(37). The few studies demonstrating significantly higher clinical cure and survival rates with linezolid therapy have been criticized for their limitations and conclusions, particularly the claim of linezolid superiority based on MRSA subgroup analyses (3,10,11,21,22).…”

mentioning

confidence: 99%

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Comparative Effectiveness of Linezolid and Vancomycin among a National Cohort of Patients Infected with Methicillin-Resistant Staphylococcus aureus

Caffrey

Quilliam

LaPlante

2010

Antimicrob Agents Chemother

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“…An infection caused by MRSA increases the risk of 90-days mortality of 70% in comparison with an infection caused by methicilin sensitive pathogen 60 . The use of linezoloid may be beneficial in MRSA soft-tissue infection treatment 61 . The eventual drug penetration into infected grafts has not been confirmed and needs to be evaluated in further studies.…”

Section: Microbiologymentioning

confidence: 99%

INFECTIOUS COMPLICATIONS OF ARTERIOVENOUS ePTFE GRAFTS FOR HEMODIALYSIS

Bachleda¹,

Utíkal²,

Kalinová³

et al. 2010

BIOMED PAP

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Clinical and economic outcomes of oral linezolid versus intravenous vancomycin in the treatment of MRSA-complicated, lower-extremity skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus

Cited by 156 publications

References 6 publications

Meta-analysis of Randomized Controlled Trials of Vancomycin for the Treatment of Patients With Gram-Positive Infections: Focus on the Study Design

Meta-analysis of Randomized Controlled Trials of Vancomycin for the Treatment of Patients With Gram-Positive Infections: Focus on the Study Design

Comparative Effectiveness of Linezolid and Vancomycin among a National Cohort of Patients Infected with Methicillin-Resistant Staphylococcus aureus

INFECTIOUS COMPLICATIONS OF ARTERIOVENOUS ePTFE GRAFTS FOR HEMODIALYSIS

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