Tascini C, Gemignani G, Doria R, Biancofiore G, Urbani L, Mosca C, Malacarne P, Papineschi F, Passaglia C, Dal Canto L, Procaccini M, Furneri G, Didoni G, Filipponi F, Menichetti F
Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
J Chemother. 2009 Jun;21(3):311-6. doi: 10.1179/joc.2009.21.3.311.
In randomized studies linezolid, indicated for Gram-positive infections, was as effective as teicoplanin in critical ill patients or was superior to teicoplanin in skin infection, pneumonia and bacteremia. We performed a 2-year comparative, retrospective study of patients treated with linezolid or teicoplanin in a single hospital for the same indications. We collected information about the type of infection, the responsible pathogen, therapy administered before study drugs, antibiotic associated with the study drugs, length of hospital stay (LOS), adverse events and outcome of the infections. The aim of the study was to evaluate the efficacy of linezolid in this retrospective patients series. Overall we identified 169 patients treated with linezolid and 91 with teicoplanin. Response to therapy, (resolution or improvement of infection) was better in patients treated with linezolid compared to teicoplanin (83.9% versus 69.2%, p=0.002). Response to therapy by type of pathogen showed the superior efficacy of linezolid against Staphylococcus aureus (including MRSA) and enterococci; although not statistically significant because of the small number of patients enrolled, they were close to significance (p<0.056 for S. aureus, p<0.055 for MRSA, p<0.061 for enterococci). Overall LOS in linezolid-treated patients was 4.6 days (p<0.041) less. Empirical use of linezolid reduced lOS by 6 days (p<0.038), especially in VAP and bacteremia patients (p<0.05). Mortality due to infection was 9.8% in both groups, and adverse events were most frequently documented in linezolid-treated patients. Linezolid was clinically superior to teicoplanin in the treatment of Gram-positive infections.
在随机研究中，用于革兰氏阳性感染的利奈唑胺在重症患者中与替考拉宁疗效相当，在皮肤感染、肺炎和菌血症方面优于替考拉宁。我们在一家医院对因相同适应症接受利奈唑胺或替考拉宁治疗的患者进行了为期2年的比较性回顾性研究。我们收集了有关感染类型、致病病原体、研究药物使用前的治疗、与研究药物相关的抗生素、住院时间（LOS）、不良事件和感染结局的信息。本研究的目的是评估利奈唑胺在这个回顾性患者系列中的疗效。总体而言，我们确定了169例接受利奈唑胺治疗的患者和91例接受替考拉宁治疗的患者。与替考拉宁相比，接受利奈唑胺治疗的患者对治疗的反应（感染消退或改善）更好（83.9%对69.2%，p=0.002）。按病原体类型划分的治疗反应显示，利奈唑胺对金黄色葡萄球菌（包括耐甲氧西林金黄色葡萄球菌）和肠球菌的疗效更优；尽管由于纳入患者数量较少无统计学意义，但接近显著性（金黄色葡萄球菌p<0.056，耐甲氧西林金黄色葡萄球菌p<0.055，肠球菌p<0.061）。利奈唑胺治疗患者的总体住院时间少4.6天（p<0.041）。经验性使用利奈唑胺使住院时间缩短6天（p<0.038），尤其是在呼吸机相关性肺炎和菌血症患者中（p<0.05）。两组因感染导致的死亡率均为9.8%，不良事件在接受利奈唑胺治疗的患者中记录最为频繁。在革兰氏阳性感染的治疗中，利奈唑胺在临床上优于替考拉宁。
