NEW YORK (Reuters Health) – Among patients hospitalized for methicillin-resistant Staphylococcus aureus infection, treatment with linezolid is as effective as “gold standard” treatment with vancomycin. In fact, length of stay is shorter with linezolid, investigators report in Antimicrobial Agents and Chemotherapy published ahead of print July 26.

The findings come from a retrospective study of a national cohort of MRSA-infected patients admitted to all Veterans Affairs hospitals over a 6-year period. The aim was to quantify the “real-world clinical impact” of linezolid compared to vancomycin in this diverse population, explain Dr. Kerry LaPlante and colleagues of the University of Rhode Island and the Veterans Affairs Medical Center in Providence.

“We identified 20,107 patients treated with linezolid (3.2%) or vancomycin (96.8%). The majority of MRSA infections occurred in Southern facilities,” the team reports. Outcomes data were adjusted based on propensity scores.

The median time from starting treatment to discharge was 6 days in the linezolid group and 9 days in the vancomycin group. The discharge rate was significantly higher among patients treated with linezolid when adjusted for propensity score (HR 1.38) and in matched propensity analyses (HR 1.70).

Furthermore, the authors report, “A significantly decreased rate of therapy discontinuation was observed in the linezolid group (adjusted HR 0.64; matched HR 0.49).”

During hospitalization, 7.6% of patients died. The median survival time was not significantly different in the two treatment groups, and neither was the readmission rate. Among patients followed after discharge, 9.2% in both groups were readmitted within a year because of MRSA infection.

“To our knowledge, this is the first national observational cohort study evaluating the impact of linezolid therapy on time to discharge, in-hospital mortality, therapy discontinuation, and readmission,” Dr. LaPlante and colleagues note. They conclude: “Among our national cohort of MRSA infected patients, linezolid was as effective as vancomycin with similar in-hospital survival and readmission rates by treatment group.”

Reference:

Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus.

Antimicrob Agents Chemother 2010.