Linezolid versus Vancomycin in Treatment of Complicated Skin and Soft Tissue Infections

Weigelt, John A.; Itani, Kamal M.F.; Stevens, Dennis L.; Lau, William; Dryden, Matthew; Knirsch, Charles

doi:10.1128/aac.49.6.2260-2266.2005

Cited by 402 publications

(288 citation statements)

References 45 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%

“…Vancomycin should also be considered equally effective for the treatment of patients with gram-positive SSTIs; linezolid can be considered an exception, but physicians should be aware that data Talbot et al, 41 2007 Corey et al, 39 2010 Wilcox et al, 40 2007 Wilcox et al, 25 2009 Wunderink et al, 26 2008 Jaksic et al, 32 2006 Kohno et al, 30 2007 Itani et al, 29 2010 Table 31 2007 Kaplan et al, 35 2003 Weigelt et al, 34 2005 Wunderink et al, 36 2003 Rubinstein et al, 38 2001 Stevens et al, 37 Overall, comparators were associated with higher treatment success in the analyses of patients with S aureus and MRSA infections. Again, only linezolid was more effective than vancomycin for S aureus infections; we also noticed a trend toward higher effectiveness of telavancin (Pϭ.09).…”

Section: Discussionmentioning

confidence: 99%

“…When patients with proven grampositive infections were analyzed alone, mortality rates were not different between linezolid and vancomycin. However, the mortality rate was higher in patients allocated to the linezolid arm with infec- 2007 Charbonneau et al, 68 1994 Cony-Makhoul et al, 71 1990 Fagon et al, 47 2000 Figuera et al, 64 1996 Itani et al, 29 2010 Kaplan et al, 35 2003 Kohno et al, 30 2007 Menichetti et al, 67 1994 Sanofi-Aventis, 54 2009 Neville et al, 65 1995 Nucci et al, 61 1998 Pfizer, 31 2007 Pertel et al, 74 2009 Pham Dang et al, 56 2001 Raad et al, 48 1999 Rehm et al, 76 2008 Sidi et al, 57 2000 Stevens et al, 37 2002 Talbot et al, 41 2007 Van Laethem et al, 60 1988 Vásquez et al, 59 1999 Weigelt et al, 34 2005 Wilcox et al, 25 2009 Wunderink et al, 26 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…The few published multi-centre studies characterising SSTI pathogens have been limited to specific types of organisms [30], with almost all reports on SSTIs in diabetic patients limited to foot infections [31][32][33]. Few studies have addressed the interaction of specific pathogens with various clinical and economic outcomes [34].…”

Section: Introductionmentioning

confidence: 99%

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Tabak²,

et al. 2010

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Aims/hypothesis Skin and soft tissue infections (SSTIs) cause substantial morbidity in persons with diabetes. There are few data on pathogens or risk factors associated with important outcomes in diabetic patients hospitalised with SSTIs. Methods Using a clinical research database from CareFusion, we identified 3,030 hospitalised diabetic patients with positive culture isolates and a diagnosis of SSTI in 97 US hospitals between 2003 and 2007. We classified the culture isolates and analysed their association with the anatomic location of infection, mortality, length of stay and hospital costs. Results The only culture isolate with a significantly increased prevalence was methicillin-resistant Staphylococcus aureus (MRSA); prevalence for infection of the foot was increased from 11.6 to 21.9% (p<0.0001) and for non-foot locations from 14.0% to 24.6% (p=0.006). Patients with non-foot (vs foot) infections were more severely ill at presentation and had higher mortality rates (2.2% vs 1.0%, p<0.05). Significant independent risk factors associated with higher mortality rates included having a polymicrobial culture with Pseudomonas aeruginosa (OR 3

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“…51 Linezolid is currently approved for skin and soft tissue infections and pneumonia due to susceptible pathogens. 52 In two controlled trials of hospital-acquired pneumonia, a trend was seen for linezolid superiority over vancomycin. 53,54 There is little data (mainly based on observational studies), on the utility of linezolid for either bacteremia, 55 or osteomyelitis.…”

Section: Linezolidmentioning

confidence: 99%

Novel pharmaceutical molecules against emerging resistant gram-positive cocci

Manfredi¹,

Sabbatani²

2010

Braz J Infect Dis

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Introduction: methicillin-and also vancomycin (glycopeptide)-resistant Gram-positive organisms have emerged as an increasingly problematic cause of hospital-acquired infections, also spreading into the community. Vancomycin (glycopeptide) resistance has emerged primarily among Enterococci, but the MIC values of vancomycin for the entire Staphylococcus species are also increasing worldwide. Material and Methods: the aim of our review is to evaluate the efficacy and tolerability of newer antibiotics with activity against methicillin-resistant and glycopeptide-resistant Gram-positive cocci, on the ground of our experience at a tertiary care metropolitan Hospital, and the most recent literature evidences in this field. Results: Quinupristin-dalfopristin, linezolid, daptomycin, and tigecycline show an excellent in vitro activity, comparable to the activity of vancomycin and teicoplanin for methicillin-resistant staphylococci, and superior to the one that vancomycin for vancomycin-resistant isolates. Dalbavancin, televancin, and oritavancin are new lipoglycopeptide agents with excellent activity against Gram-positive cocci, and have superior pharmacodynamics properties compared to vancomycin. We review the bacterial spectrum, clinical indications and practical use, pharmacologic properties, and expected adverse events and contraindications associated with each of these novel antimicrobial agents, compared with the present standard of care. Discussion: linezolid activity is substantially comparable to that of vancomycin in patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, although its penetration into the respiratory tract is exceptionally elevated. Tigecycline has activity against both Enterococus species and MRSA; it is also active against a broad spectrum of Enterobacteriaceae and anaerobes, which allows for use intraabdominal, diabetic foot and surgical infections. Daptomycin has a rapid bactericidal activity for Staphylococcus aureus and it is approved in severe complications, such as bacteremia and right-sided endocarditis. It cannot be used to treat pneumonia and respiratory diseases, due to its inactivation in the presence of pulmonary surfactant.

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Linezolid versus Vancomycin in Treatment of Complicated Skin and Soft Tissue Infections

Cited by 402 publications

References 45 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

Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost

Novel pharmaceutical molecules against emerging resistant gram-positive cocci

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