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万古霉素与利奈唑胺治疗耐甲氧西林金黄色葡萄球菌医院获得性肺炎:ZEPHyR 试验的意义。

Vancomycin versus linezolid in the treatment of methicillin-resistant Staphylococcus aureus nosocomial pneumonia: implications of the ZEPHyR trial.

机构信息

University of Michigan Hospitals and College of Pharmacy, Ann Arbor, USA.

出版信息

Ann Pharmacother. 2012 Oct;46(10):1432-5. doi: 10.1345/aph.1R221. Epub 2012 Sep 4.

DOI:10.1345/aph.1R221
PMID:22947593
Abstract

In 2003, a retrospective trial comparing linezolid versus vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) showed improved survival in the linezolid group. This led to the ZEPHyR (Linezolid in the Treatment of Subjects with Nosocomial Pneumonia Proven to Be Due to Methicillin-Resistant Staphylococcus aureus) trial comparing linezolid versus vancomycin for MRSA pneumonia, which showed a benefit for linezolid with respect to clinical response but without a survival advantage. Limitations of the study included unbalanced treatment groups at baseline and number of patients excluded to reach the per-protocol group. Results of the ZEPHyR trial do not support routine use of linezolid for the treatment of MRSA pneumonia.

摘要

2003 年,一项回顾性试验比较了利奈唑胺与万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)的效果,结果显示利奈唑胺组的生存率有所提高。这促使开展了 ZEPHyR(利奈唑胺治疗确认为耐甲氧西林金黄色葡萄球菌引起的医院获得性肺炎的患者)试验,比较利奈唑胺与万古霉素治疗 MRSA 肺炎的效果,结果显示利奈唑胺在临床反应方面有获益,但在生存率方面没有优势。该研究的局限性包括基线时治疗组不均衡以及为达到方案规定的纳入人数而排除的患者数量。ZEPHyR 试验的结果不支持常规使用利奈唑胺治疗 MRSA 肺炎。

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