Comparative-effectiveness of vancomycin and linezolid as part of guideline-recommended empiric therapy for healthcare-associated pneumonia

BMC Research Notes

Christopher R. Frei³  Russell T. Attridge¹  Eric M. Mortensen²  Kelly R. Reveles³ 

[1] Feik School of Pharmacy, University of the Incarnate Word, 4301 Broadway, CPO #99, San Antonio, TX, USA;School of Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines, Boulevard, Dallas, TX, USA;Pharmacotherapy Education and Research Center (PERC), School of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MSC-6220, San Antonio 78229-3900, TX, USA

关键词: Healthcare-associated infections;    Pneumonia;    Guidelines;    Antibiotic therapy;   

Others  :  1230131
DOI  :  10.1186/s13104-015-1396-1

 received in 2014-09-11, accepted in 2015-08-31,  发布年份 2015

【 摘 要 】

Background

Linezolid has been directly compared to vancomycin in pneumonia; however, most clinical trials have not compared outcomes specifically in the healthcare-associated pneumonia (HCAP) population. The objective of this study was to compare the effectiveness of vancomycin and linezolid in a national cohort of hospitalized veterans with HCAP.

Methods

This was a retrospective cohort study of Veterans Health Administration patients admitted to >150 hospitals across the United States between 2002 and 2007. Patients were included if they were at least 65 years old, had an ICD-9-CM code for pneumonia, had one or more HCAP risk factors, and received guideline-concordant antibiotic therapy with linezolid or vancomycin within 48 h of admission. Critically ill patients were excluded. Multivariable logistic regression models and propensity scores were used to examine the association between linezolid or vancomycin therapy and 30-day mortality.

Results

A total of 1211 patients met study criteria; 946 received vancomycin and 265 received linezolid. Thirty-day mortality was higher in patients treated with vancomycin (n = 243; 25.7 %) as compared to linezolid (n = 33; 12.5 %) (adjusted OR 2.56; 95 % CI 1.67–4.04). Vancomycin use (n = 945) was also predictive of 30-day mortality compared to linezolid use (n = 264) in the propensity score analysis (adjusted OR 2.55; 95 % CI 1.66–4.02).

Conclusion

Linezolid was associated with decreased patient mortality compared to vancomycin in a national cohort of non-critically ill, hospitalized veterans with HCAP.

【 授权许可】

   
2015 Reveles et al.

【 图 表 】

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