TY  - BOOK
AU  - Shorr, Andrew F
TI  - Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study
SN  - 1058-4838
PY  - 2012///
KW  - *Acetamides/tu [Therapeutic Use]
KW  - *Anti-Bacterial Agents/tu [Therapeutic Use]
KW  - *Cross Infection/dt [Drug Therapy]
KW  - *Methicillin-Resistant Staphylococcus aureus/de [Drug Effects]
KW  - *Oxazolidinones/tu [Therapeutic Use]
KW  - *Pneumonia, Staphylococcal/dt [Drug Therapy]
KW  - Acetamides/ad [Administration & Dosage]
KW  - Acetamides/ae [Adverse Effects]
KW  - Adult
KW  - Aged
KW  - Anti-Bacterial Agents/ad [Administration & Dosage]
KW  - Anti-Bacterial Agents/ae [Adverse Effects]
KW  - Cross Infection/mi [Microbiology]
KW  - Cross Infection/mo [Mortality]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Oxazolidinones/ad [Administration & Dosage]
KW  - Oxazolidinones/ae [Adverse Effects]
KW  - Pneumonia, Staphylococcal/mi [Microbiology]
KW  - Pneumonia, Staphylococcal/mo [Mortality]
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
KW  - Clinical Trial, Phase IV
KW  - Journal Article
KW  - Multicenter Study
KW  - Randomized Controlled Trial
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: June 1997 - present, Available in print through MWHC library: 1999 - Winter 2007
N2  - BACKGROUND: Post hoc analyses of clinical trial data suggested that linezolid may be more effective than vancomycin for treatment of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. This study prospectively assessed efficacy and safety of linezolid, compared with a dose-optimized vancomycin regimen, for treatment of MRSA nosocomial pneumonia; CONCLUSIONS: For the treatment of MRSA nosocomial pneumonia, clinical response at EOS in the PP population was significantly higher with linezolid than with vancomycin, although 60-day mortality was similar; METHODS: This was a prospective, double-blind, controlled, multicenter trial involving hospitalized adult patients with hospital-acquired or healthcare-associated MRSA pneumonia. Patients were randomized to receive intravenous linezolid (600 mg every 12 hours) or vancomycin (15 mg/kg every 12 hours) for 7-14 days. Vancomycin dose was adjusted on the basis of trough levels. The primary end point was clinical outcome at end of study (EOS) in evaluable per-protocol (PP) patients. Prespecified secondary end points included response in the modified intent-to-treat (mITT) population at end of treatment (EOT) and EOS and microbiologic response in the PP and mITT populations at EOT and EOS. Survival and safety were also evaluated; RESULTS: Of 1184 patients treated, 448 (linezolid, n = 224; vancomycin, n = 224) were included in the mITT and 348 (linezolid, n = 172; vancomycin, n = 176) in the PP population. In the PP population, 95 (57.6%) of 165 linezolid-treated patients and 81 (46.6%) of 174 vancomycin-treated patients achieved clinical success at EOS (95% confidence interval for difference, 0.5%-21.6%; P = .042). All-cause 60-day mortality was similar (linezolid, 15.7%; vancomycin, 17.0%), as was incidence of adverse events. Nephrotoxicity occurred more frequently with vancomycin (18.2%; linezolid, 8.4%)
UR  - http://dx.doi.org/10.1093/cid/cir895
ER  -