Linezolid versus vancomycin for nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus in the elderly: A retrospective cohort analysis

• Published in: The American journal of emergency medicine Vol. 35; no. 2; pp. 245 - 248
• Main Authors: Takada, Hiroaki, Hifumi, Toru, Nishimoto, Naoki, Kanemura, Takashi, Yoshioka, Hayato, Okada, Ichiro, Kiriu, Nobuaki, Inoue, Junichi, Koido, Yuichi, Kato, Hiroshi
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-02-2017
• Subjects: Emergency; Linezolid; Methicillin-resistant Staphylococcus aureus; Nosocomial pneumonia; Sequential organ failure assessment; Vancomycin; S equential organ failure assessment; N osocomial pneumonia; V ancomycin; Methicillin-resistant Staphylococcus aureus; L inezolid; Linezolid; Sequential organ failure assessment; Vancomycin; Nosocomial pneumonia
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2016.10.058

Abstract Objectives Several reports have compared the efficacy of linezolid (LZD) in Methicillin-resistant Staphylococcus aureus (MRSA) infections with that of vancomycin (VCM); however, these two antibiotics for the treatment of nosocomial MRSA pneumonia in elderly patients has not been well evaluated. The purpose of this study is to evaluate the efficacy and safety of LZD compared with VCM for the treatment of elderly patients with nosocomial MRSA pneumonia in a retrospective chart review of a cohort. Methods We included 28 consecutive patients aged ≥ 65 years hospitalized with a confirmed diagnosis of MRSA pneumonia and treated with LZD ( n = 11) or VCM ( n = 17) between November 2010 and May 2015. We collected patient, disease, and laboratory data. The primary outcome was 30-day mortality. The secondary outcomes were the sequential organ failure assessment (SOFA) total, respiratory, renal, coagulation, hepatic, cardiovascular, and central nervous system scores on days 1, 3, 7, and 14. Results There were no significant differences between the two groups with regard to baseline characteristics. The 30-day mortality rate was significantly lower in the LZD group than in the VCM group (0% vs. 41%, P = .02). The SOFA total score on days 3, 7, and 14 were significantly lower those at baseline in the LZD group ( P < .05). The SOFA respiratory score on days 14 was also significantly lower than baseline in the LZD group ( P < .05). Conclusion LZD may be more efficacious than VCM for treating elderly patients with nosocomial MRSA pneumonia.