MIAMI — Linezolid was superior to vancomycin for treatment of presumed methicillin-resistant Staphylococcus aureus-based infections in 717 patients, reported Kamal Itani, M.D., and associates in a poster presented at the joint annual meeting of the Surgical Infection Society and the Surgical Infection Society-Europe.
“We expected linezolid to be better, but it was even better than we expected,” Dr. Itani, chief of surgery at VA Boston Health Care System, said in an interview.
In this large, multinational, open-label study, patients were randomized to receive 600 mg of linezolid every 12 hours either via IV or orally, or 1 g of vancomycin via IV every 12 hours.
The treatment duration was planned to be 7–14 days, but some patients were treated for up to 21 days.
In the initial population of 717 patients, those on linezolid had a shorter mean duration of IV therapy than did those on vancomycin (1.7 days vs. 9.1 days).
Of this population, MRSA infection was confirmed in 226 patients whose mean duration of IV therapy was 1.4 days on linezolid compared with 12.4 days on vancomycin.
The clinical cure rates for all patient demographics were significantly higher among linezolid patients compared with vancomycin patients (91.7% vs. 86.0%). The most significant difference in cure rates appeared in the MRSA population—94.2% in the linezolid group vs. 83.7% in the vancomycin group.
Approximately 20% of the linezolid patients could begin with oral therapy, whereas all of the vancomycin patients had IV therapy, Dr. Itani noted in an interview.
In addition, the overall mean length of hospital stay for linezolid patients was approximately 2–3 days less than that of the vancomycin patients. These data support linezolid as the more efficient choice for complicated skin and soft tissue infections due to suspected or proven MRSA, according to Dr. Itani.
The study, supported in part by Pfizer Inc., represents the largest known superiority study of linezolid, he added.
