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

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.

This study mainly aimed to compare the clinical outcomes and associated drug safety perspective of linezolid and teicoplanin in VAMP treatment.

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.

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.

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.