Linezolid eradicates MRSA better than vancomycin from surgical-site infections.
BACKGROUND
The purpose of this analysis was to compare the efficacy of linezolid versus vancomycin in patients with suspected or proven gram-positive methicillin-resistant Staphylococcus aureus (MRSA) surgical-site infections.


METHODS
An open-label, randomized, comparator-controlled, multicenter, multinational study was conducted in hospitalized patients. Patients were randomized 1:1 to receive linezolid 600 mg (intravenous [IV] or oral) every 12 hours (n = 66) or vancomycin 1 g every 12 hours IV (n = 69) for 7 to 21 days. Patients were assessed at the test-of-cure (TOC) visit, 7 days after completing therapy.


RESULTS
Clinical success at TOC was documented in similar proportions of patients treated with linezolid or vancomycin. Of those with MRSA isolated, significantly more patients who received linezolid compared with those who received vancomycin were microbiologically cured (87% vs 48%, respectively; 95% confidence interval 16.51 to 60.27; P = 0.0022).


CONCLUSIONS
Intravenous or oral linezolid was well tolerated and superior to vancomycin in treating patients with MRSA-infected surgical-site infections.
Weigelt
John
J
Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA. jweigelt@mail.mcw.edu
Kaafarani
Haytham M A
HM
Itani
Kamal M F
KM
Swanson
Robert N
RN
D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D000069349:Linezolid; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D023303:Oxazolidinones / Q000627:therapeutic use*; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects
D000081:Acetamides; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid