Linezolid vs. vancomycin in treatment of methicillin-resistant staphylococcus aureus infections: a meta-analysis

J. Li, Q.-H. Zhao, K.-C. Huang, Z.-Q. Li, L.-Y. Zhang, D.-Y. Qin, F. Pan, W.-X. Huang

Dean’s Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. leehaillan@yeah.net

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• Pharmacology

OBJECTIVE: This study aims to explore the treatment of methicillin-resistant staphylococcus aureus (MRSA) infection by using meta-analysis method.

MATERIALS AND METHODS: Pubmed/Medline, ScienceDirect, CNKI and Wanfang database were comprehensively searched to obtain the randomized controlled trials (RCTs) on linezolid and vancomycin in the treatment of MRSA infections. We extracted features and information of included studies and selected appropriate effect models based on the heterogeneity test results. The funnel plot was used to analyze publication bias.

RESULTS: A total of seven RCTs including 5376 cases met the inclusion criteria. Meta-analysis showed that the clinical cure rate of linezolid group was higher than that of vancomycin group after treatment (OR = 1.85; 95% CI: 1.33-2.59, p<0.001) and follow-up (OR = 1.49; 95% CI: 1.17-1.91, p=0.001). In the microbiologically evaluable patients, end of therapy (EOT) MRSA clearance rate, and test of cure (TOC) MRSA clearance rate of linezolid were superior to those of vancomycin.

CONCLUSIONS: Based on the combined analysis of randomized controlled trials, the efficacy of linezolid should be better than that of vancomycin in the treatment of infections caused by MRSA, but conclusions still need to be further validated by more well-designed RCTs of a large sample.

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