Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of serious infections. Linezolid and teicoplanin are widely used in the treatment of infections caused by MRSA. However, the efficacy and safety of linezolid compared with teicoplanin remains controversial. The purpose of this study was to systematically review the efficacy and safety of linezolid versus teicoplanin for the treatment of MRSA infections. A meta-analysis was performed on the published studies. Pooled relative risk (RR) and 95% confidence interval (95% CI) were calculated to determine whether there were significant differences between the linezolid group and the teicoplanin group on the efficacy and safety. Seventeen studies were included, involving 2,040 patients. The results showed that linezolid was associated with better clinical cure rate (RR = 1.14, 95% CI = 1.08-1.21, p < 0.00001) and microbiological eradication rate (RR = 1.28, 95% CI = 1.18-1.39, p < 0.00001) compared with teicoplanin. There were no statistically significant differences between the two groups in the treatment of MRSA infections regarding the adverse events (RR = 1.15, 95% CI = 0.97-1.35, p = 0.10) and the mortality (RR = 0.85, 95% CI = 0.61-1.18, p = 0.33). The results suggest that linezolid may be a better choice for the treatment of patients with MRSA infections. However, our recommendation is that the decision about treating MRSA infections with linezolid or with teicoplanin should depend on local availability, patient population, dosage regimens, costs and safety, rather than presumed differences in efficacy.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of serious infections
Study designed randomized controlled trials (RCTs), including quasi-RCT; (2) study population consisting of patients with MRSA infections and (3) intervention therapies consisting of linezolid and teicoplanin; (4) outcome variables: the primary outcomes provided should include at least one of the following: total clinical cure, microbiological eradication, major drug adverse events and the mortality
The results showed that clinical cure between linezolid and teicoplanin for the treatment of MRSA infections were statistically significant differences
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of serious infections. Our recommendation is that the decision about treating MRSA infections with linezolid or with teicoplanin should depend on local availability, patient population, dosage regimens, costs and safety, rather than presumed differences in efficacy. Pharmacokinetic disposition of teicoplanin in patients with MRSA infections is scarce and shows extensive individual variation, while the appropriate dosage regimens for teicoplanin remain controversial [4,5,6,7]. Adverse effect, such as renal toxicity, limits its use in patients with renal dysfunction [8]. Other potential problems of treatment with linezolid include its bacteriostatic rather than bactericidal action and the high incidence of adverse events [11]
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