Effect of linezolid in ventilator-associated pneumonia caused by MRSA

Abstract

Evaluation of: Wunderink RG, Mendelson MH, Somero MS et al. Early microbiological response to linezolid vs vancomycin in ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus. Chest 134, 1200–1207 (2008).Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of ventilator-associated pneumonia (VAP), especially in patients who develop VAP late in their hospital course. Clinical failure in MRSA VAP is unacceptably high. Linezolid is an oxazolidinone antimicrobial agent that demonstrates bacteriostatic activity against MRSA and has been demonstrated to be equivalent to vancomycin in the treatment of nosocomial pneumonia. Retrospective analysis of two randomized, double-blind, studies suggests that linezolid therapy may confer clinical benefit over vancomycin in patients with MRSA VAP. Linezolid demonstrates excellent penetration into the epithelial-lining fluid and this feature has been postulated to be integral to its therapeutic benefit in MRSA VAP. This article evaluates the findings of a recently published prospective, randomized, open-label, comparator-controlled, multicenter trial that aims to compare the early microbiological efficacy of linezolid with vancomycin in the treatment of VAP caused by MRSA.