Linezolid (PNU-100766) versus Vancomycin in the Treatment of Hospitalized Patients with Nosocomial Pneumonia: A Randomized, Double-Blind, Multicenter Study

• Published in: Clinical infectious diseases 2001-02, Vol.32 (3), p.402-412
• Main Authors: Rubinstein, Ethan, Cammarata, Sue K., Oliphant, Thomas H., Wunderink, Richard G.
• Format: Article
• Language: English
• Subjects: Acetamides - adverse effects; Acetamides - therapeutic use; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobials; aztreonam; Aztreonam - therapeutic use; Bacterial pneumonia; Biological and medical sciences; Cross Infection - drug therapy; Double-Blind Method; Drug Resistance, Microbial; Drug Therapy, Combination; Gram-Positive Bacteria - drug effects; Hospitalization; Humans; Infections; Infectious diseases; Linezolid; Major Article; Male; Medical sciences; Medications; Middle Aged; Monobactams - therapeutic use; Oxazolidinones; Oxazolidinones - adverse effects; Oxazolidinones - therapeutic use; Pathogens; Pharmacology. Drug treatments; Pneumonia; Pneumonia - drug therapy; Safety; Staphylococcal pneumonia; State hospitals; Time Factors; Treatment Outcome; vancomycin; Vancomycin - adverse effects; Vancomycin - therapeutic use
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/318486

Linezolid, the first oxazolidinone, is active against gram-positive bacteria, including multidrug-resistant strains. This multinational, randomized, double-blind, controlled trial compared the efficacy, safety, and tolerability of linezolid with vancomycin in the treatment of nosocomial pneumonia. A total of 203 patients received intravenous linezolid, 600 mg twice daily, plus aztreonam, and 193 patients received vancomycin, 1 g intravenously twice daily, plus aztreonam for 7–21 days. Clinical and microbiological outcomes were evaluated at test of cure 12–28 days after treatment. Clinical cure rates (71 [66.4%] of 107 for linezolid vs. 62 [68.1%] of 91 for vancomycin) and microbiological success rates (36 [67.9%] of 53 vs. 28 [71.8%] of 39, respectively) for evaluable patients were equivalent between treatment groups. Eradication rates of methicillin-resistant Staphylococcus aureus and safety evaluations were similar between treatment groups. Resistance to either treatment was not detected. Linezolid is a well-tolerated, effective treatment for adults with gram-positive nosocomial pneumonia.