Linezolid and vancomycin in treatment of lower-extremity complicated skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus in patients with and without vascular disease. Surg Infect (Larchmt) 2012 Jun;13(3):147-53
Date
05/10/2012Pubmed ID
22568921DOI
10.1089/sur.2011.062Scopus ID
2-s2.0-84862884596 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
BACKGROUND: We evaluated drug efficacy and safety among patients with and without vascular disease who were treated with linezolid or vancomycin for a lower-extremity complicated skin and skin structure infection (cSSSI) caused by methicillin-resistant Staphylococcus aureus (MRSA).
METHODS: We pooled data from two randomized clinical trials evaluating the efficacy and safety of linezolid 600 mg intravenously (IV) or orally every 12 h and vancomycin 15 mg/kg or 1 g IV every 12 h for the treatment of cSSSI caused by culture-proved MRSA.
RESULTS: There were 477 patients for analysis. Among patients with vascular disease (linezolid n=139, vancomycin n=135), the clinical success rate was 80.4% and 66.7% (p=0.02) for patients treated with linezolid and vancomycin, respectively. Among patients without vascular disease (linezolid n=91, vancomycin n=112), the clinical success rate was 94.5% and 89.4%, respectively (p=0.24). Linezolid-treated patients had fewer IV catheter-site complications and less kidney impairment but more frequent thrombocytopenia than those who received vancomycin, regardless of the presence or absence of vascular disease.
CONCLUSION: Linezolid is an effective treatment for patients with and without vascular disease who have a lower-extremity cSSSI caused by MRSA. The safety data were consistent with the known safety profiles of linezolid and vancomycin given for this indication.
Author List
Duane TM, Weigelt JA, Puzniak LA, Huang DBMESH terms used to index this publication - Major topics in bold
AcetamidesAdministration, Oral
Aged
Anti-Bacterial Agents
Female
Humans
Infusions, Intravenous
Linezolid
Lower Extremity
Male
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Oxazolidinones
Randomized Controlled Trials as Topic
Staphylococcal Skin Infections
Treatment Outcome
Vancomycin
Vascular Diseases