Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis
Vancomycin (VCM) and daptomycin (DAP) are standard therapies for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia, despite concerns regarding clinical utility and growing resistance. Linezolid (LZD) affords superior tissue penetration to VCM or DAP and has been succes...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/4/697 |
| _version_ | 1797606713420939264 |
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| author | Hitoshi Kawasuji Kentaro Nagaoka Yasuhiro Tsuji Kou Kimoto Yusuke Takegoshi Makito Kaneda Yushi Murai Haruka Karaushi Kotaro Mitsutake Yoshihiro Yamamoto |
| author_facet | Hitoshi Kawasuji Kentaro Nagaoka Yasuhiro Tsuji Kou Kimoto Yusuke Takegoshi Makito Kaneda Yushi Murai Haruka Karaushi Kotaro Mitsutake Yoshihiro Yamamoto |
| author_sort | Hitoshi Kawasuji |
| collection | DOAJ |
| description | Vancomycin (VCM) and daptomycin (DAP) are standard therapies for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia, despite concerns regarding clinical utility and growing resistance. Linezolid (LZD) affords superior tissue penetration to VCM or DAP and has been successfully used as salvage therapy for persistent MRSA bacteremia, indicating its utility as a first-choice drug against MRSA bacteremia. In a systematic review and meta-analysis, we compared the effectiveness and safety of LZD with VCM, teicoplanin (TEIC), or DAP in patients with MRSA bacteremia. We evaluated all-cause mortality as the primary effectiveness outcome, clinical and microbiological cure, hospital length of stay, recurrence, and 90-day readmission rates as secondary effectiveness outcomes, and drug-related adverse effects as primary safety outcomes. We identified 5328 patients across 2 randomized controlled trials (RCTs), 1 pooled analysis of 5 RCTs, 1 subgroup analysis (1 RCT), and 5 case-control and cohort studies (CSs). Primary and secondary effectiveness outcomes were comparable between patients treated with LZD versus VCM, TEIC, or DAP in RCT-based studies and CSs. There was no difference in adverse event incidence between LZD and comparators. These findings suggest that LZD could be a potential first-line drug against MRSA bacteremia as well as VCM or DAP. |
| first_indexed | 2024-03-11T05:18:58Z |
| format | Article |
| id | doaj.art-7a660f514d6c400a8441f346a18eb59a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T05:18:58Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-7a660f514d6c400a8441f346a18eb59a2023-11-17T18:02:42ZengMDPI AGAntibiotics2079-63822023-04-0112469710.3390/antibiotics12040697Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-AnalysisHitoshi Kawasuji0Kentaro Nagaoka1Yasuhiro Tsuji2Kou Kimoto3Yusuke Takegoshi4Makito Kaneda5Yushi Murai6Haruka Karaushi7Kotaro Mitsutake8Yoshihiro Yamamoto9Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanLaboratory of Clinical Pharmacometrics, School of Pharmacy, Nihon University, Chiba 274-8555, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanDepartment of Infectious Diseases and Infection Control, International Medical Center, Saitama Medical University School of Medicine, Saitama 350-1298, JapanDepartment of Infectious Diseases and Infection Control, International Medical Center, Saitama Medical University School of Medicine, Saitama 350-1298, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama 930-0194, JapanVancomycin (VCM) and daptomycin (DAP) are standard therapies for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia, despite concerns regarding clinical utility and growing resistance. Linezolid (LZD) affords superior tissue penetration to VCM or DAP and has been successfully used as salvage therapy for persistent MRSA bacteremia, indicating its utility as a first-choice drug against MRSA bacteremia. In a systematic review and meta-analysis, we compared the effectiveness and safety of LZD with VCM, teicoplanin (TEIC), or DAP in patients with MRSA bacteremia. We evaluated all-cause mortality as the primary effectiveness outcome, clinical and microbiological cure, hospital length of stay, recurrence, and 90-day readmission rates as secondary effectiveness outcomes, and drug-related adverse effects as primary safety outcomes. We identified 5328 patients across 2 randomized controlled trials (RCTs), 1 pooled analysis of 5 RCTs, 1 subgroup analysis (1 RCT), and 5 case-control and cohort studies (CSs). Primary and secondary effectiveness outcomes were comparable between patients treated with LZD versus VCM, TEIC, or DAP in RCT-based studies and CSs. There was no difference in adverse event incidence between LZD and comparators. These findings suggest that LZD could be a potential first-line drug against MRSA bacteremia as well as VCM or DAP.https://www.mdpi.com/2079-6382/12/4/697meta-analysislinezolideffectivenessmethicillin-resistant <i>Staphylococcus aureus</i>bacteremia |
| spellingShingle | Hitoshi Kawasuji Kentaro Nagaoka Yasuhiro Tsuji Kou Kimoto Yusuke Takegoshi Makito Kaneda Yushi Murai Haruka Karaushi Kotaro Mitsutake Yoshihiro Yamamoto Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis Antibiotics meta-analysis linezolid effectiveness methicillin-resistant <i>Staphylococcus aureus</i> bacteremia |
| title | Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis |
| title_full | Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis |
| title_fullStr | Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis |
| title_short | Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: A Systematic Review and Meta-Analysis |
| title_sort | effectiveness and safety of linezolid versus vancomycin teicoplanin or daptomycin against methicillin resistant i staphylococcus aureus i bacteremia a systematic review and meta analysis |
| topic | meta-analysis linezolid effectiveness methicillin-resistant <i>Staphylococcus aureus</i> bacteremia |
| url | https://www.mdpi.com/2079-6382/12/4/697 |
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