Vancomycin Alternative for MRSA Infections

A large comparison study of treatments for methicillin-resistant Staphylococcus aureus (MRSA) infections has shown that linezolid is an effective alternative to vancomycin for such MRSA infections as hospital-acquired pneumonia and bacteremia. The results were published in the June 1, 2002, issue of Clinical Infectious Diseases.

Linezolid (Zyvox) is the first of a new class of antibiotics, the oxazolidinones. The drug has a mechanism of action unlike any current antibiotic. The study involved 460 patients with suspected or proven MRSA infections at 104 sites in North America, Latin America, Europe, and Asia. Linezolid was found to be clinically and microbiologically as effective as standard vancomycin therapy for MRSA infections, including skin and soft tissue infections and urinary tract infections. Patients were randomized to receive either oral or intravenous (IV) linesolid or vancomycin.

After improvement, linezolid IV-treated patients could be switched to oral linezolid. In the study, 61% of patients receiving linezolid were switched to oral therapy. Earlier data from this study showed that use of oral linezolid resulted in a five-day decrease in hospital length of stay for patients with skin and soft tissue infections, compared to vancomycin. Linezolid-resistance to S aureus was not detected in this study, conducted by US Department of Veterans Affairs (VA) in Los Angeles (CA, USA).

"We now have conclusive evidence that linezolid is as effective as vancomycin in MRSA infections, with the added advantage to the clinician and patient of being used either intravenously or orally,” said Dr. Dennis Stevens, lead investigator and chief, infectious diseases, Boise VA Medical Center (Idaho, USA).