OBJECTIVE: To compare outcomes of treating complicated skin and skin structure infections (cSSSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) with linezolid versus vancomycin in diabetic and non-diabetic patients. METHODS: We pooled data from three prospective clinical trials in which 1056 patients were randomized to receive either linezolid (intravenous (IV) or oral) or vancomycin (IV) every 12h, for 7-28 days. RESULTS:Diabetic (n=349) and non-diabetic patients (n=707) had comparable demographics and co-morbidities. Clinical success rates were lower in diabetic than in non-diabetic patients (72.3% and 85.8%, respectively). Overall, non-diabetic patients had a shorter adjusted mean length of stay (LOS) compared with diabetic patients (8.2 and 10.7 days, respectively; p<0.0001). Among diabetic patients, rates were comparable with linezolid and vancomycin treatment for clinical success (74% and 71%, respectively) and microbiological success (60% and 54%, respectively). Among non-diabetic patients, clinical and microbiological success rates were higher in linezolid- than in vancomycin-treated patients (90% and 81%, respectively, and 78% and 65%, respectively). Rates of drug-related adverse events were comparable in diabetic and non-diabetic patients and with linezolid and vancomycin treatment. Adjusted mean LOS was shorter with linezolid than with vancomycin treatment in diabetic patients (9.5 and 11.7 days, respectively; p=0.03) and non-diabetic patients (7.6 and 8.9 days, respectively; p=0.02). CONCLUSIONS:Clinical success rates were lower in diabetic than non-diabetic patients with cSSSI caused by MRSA. Comparing linezolid and vancomycin, clinical and microbiological success rates were comparable in diabetic patients, but were better for linezolid than for vancomycin in non-diabetic patients.
RCT Entities:
OBJECTIVE: To compare outcomes of treating complicated skin and skin structure infections (cSSSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) with linezolid versus vancomycin in diabetic and non-diabeticpatients. METHODS: We pooled data from three prospective clinical trials in which 1056 patients were randomized to receive either linezolid (intravenous (IV) or oral) or vancomycin (IV) every 12h, for 7-28 days. RESULTS:Diabetic (n=349) and non-diabeticpatients (n=707) had comparable demographics and co-morbidities. Clinical success rates were lower in diabetic than in non-diabeticpatients (72.3% and 85.8%, respectively). Overall, non-diabeticpatients had a shorter adjusted mean length of stay (LOS) compared with diabeticpatients (8.2 and 10.7 days, respectively; p<0.0001). Among diabeticpatients, rates were comparable with linezolid and vancomycin treatment for clinical success (74% and 71%, respectively) and microbiological success (60% and 54%, respectively). Among non-diabeticpatients, clinical and microbiological success rates were higher in linezolid- than in vancomycin-treated patients (90% and 81%, respectively, and 78% and 65%, respectively). Rates of drug-related adverse events were comparable in diabetic and non-diabeticpatients and with linezolid and vancomycin treatment. Adjusted mean LOS was shorter with linezolid than with vancomycin treatment in diabeticpatients (9.5 and 11.7 days, respectively; p=0.03) and non-diabeticpatients (7.6 and 8.9 days, respectively; p=0.02). CONCLUSIONS: Clinical success rates were lower in diabetic than non-diabeticpatients with cSSSI caused by MRSA. Comparing linezolid and vancomycin, clinical and microbiological success rates were comparable in diabeticpatients, but were better for linezolid than for vancomycin in non-diabeticpatients.
Authors: Sujata M Bhavnani; Jeffrey P Hammel; Scott A Van Wart; Christopher M Rubino; Daniel K Reynolds; Alan Forrest; George L Drusano; Tatiana Khariton; H David Friedland; Todd A Riccobene; Paul G Ambrose Journal: Antimicrob Agents Chemother Date: 2014-11-03 Impact factor: 5.191
Authors: W T Prince; Z Ivezic-Schoenfeld; C Lell; K J Tack; R Novak; F Obermayr; G H Talbot Journal: Antimicrob Agents Chemother Date: 2013-02-19 Impact factor: 5.191
Authors: Yi Guo; Romela Irene Ramos; John S Cho; Niles P Donegan; Ambrose L Cheung; Lloyd S Miller Journal: Antimicrob Agents Chemother Date: 2012-12-03 Impact factor: 5.191
Authors: Vladimíra Fejfarová; Alexandra Jirkovská; Michal Dubský; Frances Game; Jana Vydláková; Alena Sekerková; Jana Franeková; Monika Kučerová; Ilja Stříž; Vladimír Petkov; Robert Bém; Veronika Wosková; Andrea Němcová; Jelena Skibová Journal: J Diabetes Res Date: 2016-12-05 Impact factor: 4.011