机构:[1]Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China,[2]Guangdong Key Laboratory of Molecular Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China,[3]Department of Laboratory Medicine, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi, China,[4]Department of Laboratory Medicine, Guangzhou High Education Mega Centre Hospital, Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China大德路总院检验科大德路总院检验科广东省中医院
To assess the effectiveness and safety of linezolid in comparison with glycopeptides (vancomycin and teicoplanin) for the treatment of Staphylococcus aureus infections, we conducted a meta-analysis of relevant randomized controlled trials. A thorough search of Pubmed and other databases was performed. Thirteen trials on 3863 clinically assessed patients were included. Linezolid was slightly more effective than glycopeptides in the intent-to-treat population (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.10), was more effective in clinically assessed patients (OR 95% CI: 1.38, 1.17-1.64) and in all microbiologically assessed patients (OR 95% CI: 1.38, 1.15-1.65). Linezolid was associated with better treatment in skin and soft-tissue infections (SSTIs) patients (OR 95% CI: 1.61, 1.22-2.12), but not in bacteraemia (OR 95% CI: 1.24, 0.78-1.97) or pneumonia (OR 95% CI: 1.25, 0.97-1.60) patients. No difference of mortality between linezolid and glycopeptides was seen in the pooled trials (OR 95% CI: 0.98, 0.83-1.15). While linezolid was associated with more haematological (OR 95% CI: 2.23, 1.07-4.65) and gastrointestinal events (OR 95% CI: 2.34, 1.53-3.59), a significantly fewer events of skin adverse effects (OR 95% CI: 0.27, 0.16-0.46) and nephrotoxicity (OR 95% CI: 0.45, 0.28-0.72) were recorded in linezolid. Based on the analysis of the pooled data of randomized control trials, linezolid should be a better choice for treatment of patients with S. aureus infections, especially in SSTIs patients than glycopeptides. However, when physicians choose to use linezolid, risk of haematological and gastrointestinal events should be taken into account according to the characteristics of the specific patient populations.
基金:
Guangdong Natural Science Foundation (No. S2011010002481).
第一作者机构:[1]Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China,[2]Guangdong Key Laboratory of Molecular Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China,[3]Department of Laboratory Medicine, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi, China,
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推荐引用方式(GB/T 7714):
Fu Jinjian,Ye Xiaohua,Chen Cha,et al.The Efficacy and Safety of Linezolid and Glycopeptides in the Treatment of Staphylococcus aureus Infections[J].PLOS ONE.2013,8(3):doi:10.1371/journal.pone.0058240.
APA:
Fu, Jinjian,Ye, Xiaohua,Chen, Cha&Chen, Sidong.(2013).The Efficacy and Safety of Linezolid and Glycopeptides in the Treatment of Staphylococcus aureus Infections.PLOS ONE,8,(3)
MLA:
Fu, Jinjian,et al."The Efficacy and Safety of Linezolid and Glycopeptides in the Treatment of Staphylococcus aureus Infections".PLOS ONE 8..3(2013)