Linezolid Versus Vancomycin in the Empiric Treatment of Nosocomial Pneumonia: A Cost-Utility Analysis Incorporating Results from the ZEPHyR Trial

Collins, Curtis D.; Schwemm, Ann K.

doi:10.1016/j.jval.2015.04.007

Cited by 16 publications

(20 citation statements)

References 34 publications

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“…HAP caused an increase of $11,897 to $25,072 per incident and was the leading cause of death in all nosocomial infections [49]. In four pharmacoeconomic analyses comparing vancomycin and linezolid in the treatment of pneumonia, efficacy and cost data were obtained from published RCTs [50–53]. Our results confirmed the results of previous analyses and showed that despite its higher cost, linezolid was cost-effective for treatment of MRSA pneumonia.…”

Section: Discussionsupporting

confidence: 83%

Network meta-analysis and pharmacoeconomic evaluation of antibiotics for the treatment of patients infected with complicated skin and soft structure infection and hospital-acquired or ventilator-associated penumonia

Zhang

Wang

Driel

et al. 2019

Antimicrob Resist Infect Control

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Background Infections due to methicillin-resistant Staphylococcus aureus ( MRSA) cause serious health risks and significant economic burdens and the preferred drugs are still controversial. Methods We performed a network meta-analysis (NMA) to compare the efficacy and safety of antibiotics used to treat inpatients with complicated skin and soft structure infections (cSSSI) or hospital-acquired or ventilator-associated pneumonia (HAP/VAP). We also developed a decision tree model to assess the cost-effectiveness of antibiotics. Results Forty-nine randomized controlled trials met the inclusion criteria (34 for cSSSI, 15 for HAP/VAP) and compared the efficacy and safety of 16 antibiotics. For cSSSI, NMA indicated that for clinical cure, linezolid was superior than vancomycin (odds ratio (OR) 1.55, 95% confidence interval (CI) 1.19–2.02), while tedizolid (OR 1.39, CI 0.70–2.76) was similar to vancomycin. In terms of safety, there were no significant differences between any two interventions on total adverse events. Based on drug and hospital costs in America, the incremental cost-effectiveness ratios (ICERs) per life-year saved for linezolid and tedizolid compared with vancomycin were US$2833 and US$5523. For HAP/VAP, there were no significant effects either for clinical cure or for safety endpoints between linezolid and vancomycin in NMA. ICERs per life-year saved for linezolid compared with vancomycin were US$2185. Conclusion In these clinical trials, considering efficacy, safety, and cost-effectivenes, linezolid and tedizolid showed their superiority in MRSA cSSSI; while linezolid might be recommended to treat MRSA pneumonia. Although vancomycin was not cost-effective in pharmacoeconomic evaluation, it is still the first-line treatment for MRSA infection in the clinical practice. This study might provide new insights of therapeutic choices for patients with MRSA infections whilst awaiting the arrival of higher quality evidence. Electronic supplementary material The online version of this article (10.1186/s13756-019-0518-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 83%

Network meta-analysis and pharmacoeconomic evaluation of antibiotics for the treatment of patients infected with complicated skin and soft structure infection and hospital-acquired or ventilator-associated penumonia

Zhang

Wang

Driel

et al. 2019

Antimicrob Resist Infect Control

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“…In a Chinese perspective, linezolid was more cost-effective than vancomycin, considering adverse effects of this drug 23 . Other studies from different points of view showed similar results with our study 24,25 . The theorical burden of vancomycin related renal failure is questionable in cost-analysis publications 26 .…”

Section: Discussionsupporting

confidence: 92%

A atuação do enfermeiro e dos cuidadores na assistência ao paciente portador de demência / The performance of nurses and caregivers in care for patients with dementia

Schiochet¹,

Dubena²,

Argenton³

2021

Braz. J. Hea. Rev.

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“…Some studies demonstrated that administration of linezolid is more cost-effective than vancomycin in the treatment of MRSA infection because of earlier discharge from the hospital. 66 , 67 Generally, linezolid may reduce mortality of patients compared to vancomycin. 68 , 69 …”

Section: Comparison With Other Antibioticsmentioning

confidence: 99%

Linezolid: a review of its properties, function, and use in critical care

Hashemian¹,

Farhadi²,

Ganjparvar³

2018

DDDT

309

193

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Linezolid can be considered as the first member of the class of oxazolidinone antibiotics. The compound is a synthetic antibiotic that inhibits bacterial protein synthesis through binding to rRNA. It also inhibits the creation of the initiation complex during protein synthesis which can reduce the length of the developed peptide chains, and decrease the rate of reaction of translation elongation. Linezolid has been approved for the treatment of infections caused by vancomycin-resistant Enterococcus faecium, hospital-acquired pneumonia caused by Staphylococcus aureus, complicated skin and skin structure infections (SSSIs), uncomplicated SSSIs caused by methicillin-susceptible S. aureus or Streptococcus pyogenes, and community-acquired pneumonia caused by Streptococcus pneumoniae. Analysis of high-resolution structures of linezolid has demonstrated that it binds a deep cleft of the 50S ribosomal subunit that is surrounded by 23S rRNA nucleotides. Mutation of 23S rRNA was shown to be a linezolid resistance mechanism. Besides, mutations in specific regions of ribosomal proteins uL3 and uL4 are increasingly associated with linezolid resistance. However, these proteins are located further away from the bound drug. The methicillin-resistant S. aureus and vancomycin-resistant enterococci are considered the most common Gram-positive bacteria found in intensive care units (ICUs), and linezolid, as an antimicrobial drug, is commonly utilized to treat infected ICU patients. The drug has favorable in vitro and in vivo activity against the mentioned organisms and is considered as a useful antibiotic to treat infections in the ICU.

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Linezolid Versus Vancomycin in the Empiric Treatment of Nosocomial Pneumonia: A Cost-Utility Analysis Incorporating Results from the ZEPHyR Trial

Cited by 16 publications

References 34 publications

Network meta-analysis and pharmacoeconomic evaluation of antibiotics for the treatment of patients infected with complicated skin and soft structure infection and hospital-acquired or ventilator-associated penumonia

Network meta-analysis and pharmacoeconomic evaluation of antibiotics for the treatment of patients infected with complicated skin and soft structure infection and hospital-acquired or ventilator-associated penumonia

A atuação do enfermeiro e dos cuidadores na assistência ao paciente portador de demência / The performance of nurses and caregivers in care for patients with dementia

Linezolid: a review of its properties, function, and use in critical care

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