The results suggest that linezolid is a safe and effective treatment for gram-positive bacterial infections.
Illustration of Corynebacterium diphtheriae bacteria, rod-shaped gram-positive bacteria that cause respiratory infections, diphtheria and also skin lesions. Photo: Shutterstock.
According to a study published in Journal of Intensive Medicineit was found that during one study approximately 80% of the patients in intensive care showed clinical improvement in gram-positive bacterial infections following treatment with linezolidaccording to data from more than 300 people.
The researchers stressed that bacterial infections remain a challenge in the management of critically ill patients because many gram-positive pathogens have become resistant to multiple drug options.
The authors stated that linezolid demonstrated efficacy once morest the Staphylococcus aureus resistant to methicilin (MRSA) and infections of the skin and soft tissues (SSTI), but its use has not been characterized in critically ill patients with gram-positive infections in the UCI
Aijia Ma, MD, del Hospital de China western of the University of Sichuan, SichuanChina, and colleagues noted that patients were treated with linezolid injections (200 mg/100 mL) and followed once daily for up to 48 hours following discontinuation of therapy, transfer out of the ICU, or death.
“Most of the patients (243) were older than 65 years; 90 were between 18 and 65 years old and 30 were younger than 18 years old. Approximately two-thirds (67%) were men. The result Primary Clinical Efficacy was the success (cured or improved), they wrote in their post.
The investigation revealed that Linezolid was used as second and first line treatment in 232 (63.4%) and 134 (36.6%) patients, respectively.
“The most common strain isolated was Staphylococcus aureus (31% MRSA; 12.6% methicillin-sensitive S. aureus [MSSA]), followed by enterococci (6.7% resistant to vancomycin; 9.2% sensitive to vancomycin) and Streptococcus pneumoniae (3.4% multidrug resistant; 1.7% multidrug resistant)”, highlighted.
Overall, 82.2% of patients met criteria for clinical success; 34 (9.3%) were cured and 267 (73%) improved. Clinical success rates for first-line and second-line linezolid treatment were 79.9% and 83.6%, respectively. The failure rates for linezolid they were higher for second-line treatment than for first-line (9.5% vs. 5.2%).
The clinical success rate was highest once morest MSSA (93.3%), followed by MRSA (83.8%). The mean daily dose of linezolid was, 1109 mg and mean treatment time it was 5.1 days.
A total of 8 patients (2.2%) reported linezolid-related adverse events and 4 patients discontinued the drug because of them; none reported serious adverse events related to treatment. The low incidence of thrombocytopenia in the current study (2 patients) compared to earlier studies may have been related to linezolid avoidance for patients at risk, as determined by clinicians, and the relatively short duration of linezolid use, the researchers wrote in their discussion .
The results suggest that linezolid is a safe treatment and effective for gram-positive bacterial infections, although clinicians should pay close attention to potential side effects and assess individual patient conditions before using linezolid in the clinic, they concluded.
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