Comparative Evaluation of Linezolid and Teicoplanin in the Treatment of Ventilator-Associated MRSA Pneumonia: A Single-Center Experience

Abstract

Background: Ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious infection in an intensive care unit (ICU). Ventilator-associated MRSA pneumonia (VAMP) in critically ill patients causes a high rate of mortality. Objectives: This study mainly aimed to compare the clinical outcomes and associated drug safety perspective of linezolid and teicoplanin in VAMP treatment. Methods: This retrospective study included 98 adult ICU patients with VAMP, where 42 patients (LZD group) and 56 patients (TPN group) received a standard dose of linezolid and teicoplanin, respectively, for their VAMP treatment. Adverse reactions associated with linezolid and teicoplanin were considered. Clinical outcomes and 30-day mortality rates were compared in both groups. Results: The LZD group showed a higher MRSA eradication rate (97%, n = 34) than the TPN group (94.3%, n = 53) (P = 0.034). The linezolid and teicoplanin therapy was suddenly discontinued in 19% and 5.3% of the patients in the LZD and TPN groups, respectively, before completing the full duration of antibiotic therapy due to developed adverse drug reactions (ADRs), including thrombocytopenia (LZD/TPN groups: 7/1 event), tachycardia (LZD group: 1 event), and nephrotoxicity (TPN group: 2 events). This discontinuation increased the total duration of antibiotic therapy in 19% (n = 42) and 5.3% (n = 56) of the patients (P = 0.034) in the LZD and TPN groups, respectively. Conclusions: VAMP is a life-threatening event in critically ill ICU patients worldwide. In this study, teicoplanin showed better clinical outcomes with a certain higher level of drug safety compared to linezolid in the treatment of ventilator-associated MRSA pneumonia.