Linezolid or vanc for MRSA coverage in nosocomial pneumonia?

In a meta-analysis of 7 trials there was no significant difference in cure rate or mortality. Not surprising was double the incidence of thrombocytopenia with linezolid. Somewhat surprising was a marked increase in “GI events” with linezolid. The authors did not indicate what the events were. There was more renal failure in the vanc group but the difference was not statistically significant (very wide confidence interval). Vancomycin MICs were not reported. That would have been of great interest in view of all the troubling reports of frequent vancomycin treatment failures associated with higher MICs even when in the “sensitive” range.


Via the Medicine for Residents blog.