Vancomycin or linezolid for skin or bloodstream infections

In this industry-sponsored phase-3 trial of patients with skin/skin-structure infections or catheter-related bloodstream infections with gram positive organisms, linezolid was non-inferior to vancomycin. For skin infections, clinical success rates were 90% in each group. For catheter related bloodstream infections, microbiologic success rates were 86% for linezolid and 91% for vancomycin (abstract). Linezolid is currently FDA approved to treat VRE infections, as well as pneumonia (nosocomial and community-acquired) and skin/skin-structure infections caused by resistant gram-positive organisms (FDA sheet). Based on this study, it can reasonably be used for resistant gram-positive bacteremia, when vancomycin cannot be used.

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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