Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study.
Linezolid, the first oxazolidinone, is active against gram-positive bacteria, including multidrug-resistant strains. This multinational, randomized, double-blind, controlled trial compared the efficacy, safety, and tolerability of linezolid with vancomycin in the treatment of nosocomial pneumonia. A total of 203 patients received intravenous linezolid, 600 mg twice daily, plus aztreonam, and 193 patients received vancomycin, 1 g intravenously twice daily, plus aztreonam for 7-21 days. Clinical and microbiological outcomes were evaluated at test of cure 12-28 days after treatment. Clinical cure rates (71 [66.4%] of 107 for linezolid vs. 62 [68.1%] of 91 for vancomycin) and microbiological success rates (36 [67.9%] of 53 vs. 28 [71.8%] of 39, respectively) for evaluable patients were equivalent between treatment groups. Eradication rates of methicillin-resistant Staphylococcus aureus and safety evaluations were similar between treatment groups. Resistance to either treatment was not detected. Linezolid is a well-tolerated, effective treatment for adults with gram-positive nosocomial pneumonia.
Rubinstein
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E
Infectious Diseases Unit, The Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Hashomer, Israel. erubins@yahoo.com
Cammarata
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S
Oliphant
T
T
Wunderink
R
R
D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001398:Aztreonam / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy*; D004311:Double-Blind Method; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006760:Hospitalization; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D008997:Monobactams / Q000627:therapeutic use; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D011014:Pneumonia / Q000188:drug therapy*; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use*
D000081:Acetamides; D000900:Anti-Bacterial Agents; D008997:Monobactams; D023303:Oxazolidinones; D014640:Vancomycin; D001398:Aztreonam; D000069349:Linezolid