Linezolid versus Vancomycin for Gram-positive Bacteraemia: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

YUE Jirong , FANG Chenli , ZHANG Xuemei ,  DONG Birong

Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

DONG Birong, Email: birongdong@163.com

Keywords：

Gram-positive bacteraemia; Linezolid; Vancomycin; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.20090117

Video：

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Objective 　To compare the effectiveness and safety of linezolid with vancomycin for the treatment of people with Gram-positive bacteraemia.
Methods 　We electronically searched The Cochrane Library (Issue 1, 2009), MEDLINE, EMbase, Current Controlled Trials, The National Research Register, CBM disc and CNKI. We also handsearched some relevant journals. The search time was up to March 10, 2009. Randomized controlled trials of linezolid versus vancomycin for treatment of Gram-positive bacteraemia were included. Meta-analyses were performed for the results of homogeneous studies using the Cochrane Collaboration’s RevMan 5.0 software.
Results 　A total of 8 randomized controlled trials involving 670 patients with Gram-positive bacteraemia were included. The results indicated that there was no significant difference between linezolid and vancomycin groups in treatment of Gram-positive bacteraemia [RR= 1.07, 95%CI (0.98,1.17), P= 0.15], MRSA bacteraemia [RR=1.22, 95%CI (0.97,1.53), P= 0.10] or catheter-related bacteraemia [RR= 1.01, 95%CI (0.86,1.19), P= 0.90]. There was no difference between groups in the total adverse effect (P=0.64). The rate of renal dysfunction was higher in vancomycin group (P=0.0003) and the rate of thrombopenia was higher in linezolid group (P=0.01).
Conclusion 　Linezolid is associated with the outcomes that are not inferior to those of vancomycin in the patients with Gram-positive bacteraemia. More high-quality, large-scale randomized controlled trials exclusive for the bacteraemia are required.

Citation： YUE Jirong,FANG Chenli,ZHANG Xuemei,DONG Birong. Linezolid versus Vancomycin for Gram-positive Bacteraemia: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(6): 646-651. doi: 10.7507/1672-2531.20090117 Copy

1.	Abramson MA, Sexton DJ. Nosocomial methicillin-resistant and methicillin-susceptible Staphylococcus aureus primary bacteremia: at what costs? Infect Control Hosp Epidemiol, 1999, 20(6): 408-411.
2.	Chang S, Sievert DM, Hageman JC, et al. Infection with vancomycin-resistant Staphylococcus aureus containing vanA resistance gene. N Engl J Med, 2003, 348(14): 1342.
3.	Fung HB, Kirschenbaum HL, Ojofeitimi BO. Linezolid: an oxazolidinone antimicrobial agent. Clinical Therapeutics, 2001, 23(3): 356-391.
4.	Rubinstein E, Cammarata SK, Oliphant TH, et al. Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study. Clin Infect Dis, 2001, 32(3): 402-412.
5.	Kaplan SL, Patterson L, Edwards KM, et al. Linezolid for the treatment of community-acquired pneumonia in hospitalized children. Pediatr Infect Dis J, 2001, 20(3): 488-494.
6.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochranehandbook.org.
7.	吴泰相, 刘关键. 隐藏分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
8.	Deville JG, Adler S, Azimi PH, et al. Linezolid versus vancomycin in the treatment of known or suspected resistant gram-positive infections in neonates. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S158-S163.
9.	Jaksic B, Martinelli G, Perez-Oteyza J, et al. Efficacy and safety of linezolid compared with vancomycin in a randomized, double-blind study of febrile neutropenic patients with cancer.[see comment]. Clinical Infectious Diseases, 2006, 42(5): 597-607.
10.	Jantausch BA, Deville J, Adler S, et al. Linezolid for the treatment of children with bacteremia or nosocomial pneumonia caused by resistant gram-positive bacterial pathogens. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S164-S171.
11.	Kaplan SL, Afghani B, Lopez P, et al. Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S178-S185.
12.	Kaplan SL, Deville JG, Yogev R, et al. Linezolid versus vancomycin for treatment of resistant Gram-positive infections in children. Pediatric Infectious Disease Journal, 2003, 22(8): 677-686.
13.	Kohno S, Yamaguchi K, Aikawa N, et al. Linezolid versus vancomycin for the treatment of infections caused by methicillin-resistant Staphylococcus aureus in Japan. Journal of Antimicrobial Chemotherapy, 2007, 60(6): 1361-1369.
14.	Stevens DL, Herr D, Lampiris H, et al. Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections. Clinical Infectious Diseases, 2002, 34(11): 1481-1490.
15.	Wilcox MH, Tack KJ, Bouza E, et al. Complicated skin and skin-structure infections and catheter-related bloodstream infections: noninferiority of linezolid in a phase 3 study. Clinical Infectious Diseases, 2009, 48(2): 203-212.
16.	Johnson LB, Almoujahed MO, Ilg K, et al. Staphylococcus aureus bacteremia: compliance with standard treatment, long-term outcome and predictors of relapse. Scand J Infect Dis, 2003, 35(11-12): 782-789.
17.	Chang FY, Peacock JE Jr, Musher DM, et al. Staphylococcus aureus bacteremia: recurrence and the impact of antibiotic treatment in a prospective multicenter study. Medicine (Baltimore), 2003, 82(5): 333-339.
18.	Moellering RC Jr. A novel antimicrobial agent joins the battle against resistant bacteria. Annals of Internal Medicine, 1999, 130(2): 155-157.
19.	Falagas ME, Siempos II, Vardakas KZ. Linezolid versus glycopeptide or (beta)-lactam for treatment of Gram-positive bacterial infections: meta-analysis of randomised controlled trials. The Lancet Infectious Diseases, 2008, 8(1): 53-66.
20.	Shorr AF, Kunkel MJ, Kollef M. Linezolid versus vancomycin for Staphylococcus aureus bacteraemia: Pooled analysis of randomized studies. Journal of Antimicrobial Chemotherapy, 2005, 56(5): 923-929.
21.	Yael W. waknine Off-Label use of Linezolid Linked to Increased Death Risk [EB/OL]. (2007-03-19). http://www.medscape.com/viewarticle/553803.

1. Abramson MA, Sexton DJ. Nosocomial methicillin-resistant and methicillin-susceptible Staphylococcus aureus primary bacteremia: at what costs? Infect Control Hosp Epidemiol, 1999, 20(6): 408-411.
2. Chang S, Sievert DM, Hageman JC, et al. Infection with vancomycin-resistant Staphylococcus aureus containing vanA resistance gene. N Engl J Med, 2003, 348(14): 1342.
3. Fung HB, Kirschenbaum HL, Ojofeitimi BO. Linezolid: an oxazolidinone antimicrobial agent. Clinical Therapeutics, 2001, 23(3): 356-391.
4. Rubinstein E, Cammarata SK, Oliphant TH, et al. Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study. Clin Infect Dis, 2001, 32(3): 402-412.
5. Kaplan SL, Patterson L, Edwards KM, et al. Linezolid for the treatment of community-acquired pneumonia in hospitalized children. Pediatr Infect Dis J, 2001, 20(3): 488-494.
6. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochranehandbook.org.
7. 吴泰相, 刘关键. 隐藏分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
8. Deville JG, Adler S, Azimi PH, et al. Linezolid versus vancomycin in the treatment of known or suspected resistant gram-positive infections in neonates. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S158-S163.
9. Jaksic B, Martinelli G, Perez-Oteyza J, et al. Efficacy and safety of linezolid compared with vancomycin in a randomized, double-blind study of febrile neutropenic patients with cancer.[see comment]. Clinical Infectious Diseases, 2006, 42(5): 597-607.
10. Jantausch BA, Deville J, Adler S, et al. Linezolid for the treatment of children with bacteremia or nosocomial pneumonia caused by resistant gram-positive bacterial pathogens. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S164-S171.
11. Kaplan SL, Afghani B, Lopez P, et al. Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatric Infectious Disease Journal, 2003, 22(9 Suppl): S178-S185.
12. Kaplan SL, Deville JG, Yogev R, et al. Linezolid versus vancomycin for treatment of resistant Gram-positive infections in children. Pediatric Infectious Disease Journal, 2003, 22(8): 677-686.
13. Kohno S, Yamaguchi K, Aikawa N, et al. Linezolid versus vancomycin for the treatment of infections caused by methicillin-resistant Staphylococcus aureus in Japan. Journal of Antimicrobial Chemotherapy, 2007, 60(6): 1361-1369.
14. Stevens DL, Herr D, Lampiris H, et al. Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections. Clinical Infectious Diseases, 2002, 34(11): 1481-1490.
15. Wilcox MH, Tack KJ, Bouza E, et al. Complicated skin and skin-structure infections and catheter-related bloodstream infections: noninferiority of linezolid in a phase 3 study. Clinical Infectious Diseases, 2009, 48(2): 203-212.
16. Johnson LB, Almoujahed MO, Ilg K, et al. Staphylococcus aureus bacteremia: compliance with standard treatment, long-term outcome and predictors of relapse. Scand J Infect Dis, 2003, 35(11-12): 782-789.
17. Chang FY, Peacock JE Jr, Musher DM, et al. Staphylococcus aureus bacteremia: recurrence and the impact of antibiotic treatment in a prospective multicenter study. Medicine (Baltimore), 2003, 82(5): 333-339.
18. Moellering RC Jr. A novel antimicrobial agent joins the battle against resistant bacteria. Annals of Internal Medicine, 1999, 130(2): 155-157.
19. Falagas ME, Siempos II, Vardakas KZ. Linezolid versus glycopeptide or (beta)-lactam for treatment of Gram-positive bacterial infections: meta-analysis of randomised controlled trials. The Lancet Infectious Diseases, 2008, 8(1): 53-66.
20. Shorr AF, Kunkel MJ, Kollef M. Linezolid versus vancomycin for Staphylococcus aureus bacteraemia: Pooled analysis of randomized studies. Journal of Antimicrobial Chemotherapy, 2005, 56(5): 923-929.
21. Yael W. waknine Off-Label use of Linezolid Linked to Increased Death Risk [EB/OL]. (2007-03-19). http://www.medscape.com/viewarticle/553803.

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Linezolid versus Vancomycin for Gram-positive Bacteraemia: A Systematic Review

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