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Using Linezolid Instead of Vancomycin to Treat Serious Infections Means Fewer Rehospitalisations: Presented at IDSA

By Ed Susman

PHILADELPHIA -- November 1, 2009 -- Treatment with the antibiotic linezolid appears to prevent fewer rehospitalisations than does vancomycin for a number of infections, including staphylococcal infections, according to research presented here at the 47th Annual Meeting of the Infectious Diseases Society of America (IDSA).

"There seems to be a compelling message here," stated C. Daniel Mullins, PhD, Pharmaceutical Health Sciences Research, University of Maryland School of Pharmacy, Baltimore, Maryland, speaking at his poster presentation here on October 30. "Although vancomycin is a less expensive drug, linezolid prevents very expensive hospitalisations."

Dr. Mullins and colleagues mined the HealthCore Integrated Research Database for adults not on Medicare who were hospitalised for pneumonia (n = 1,152), staphylococcal infection (n = 2,997), or skin and soft-tissue infections (n = 6,799) and were prescribed either vancomycin or linezolid.

Of patients treated with vancomycin for pneumonia, 39.9% were rehospitalised within 6 months of discharge compared with 33.7% of those who were treated with linezolid.

Of patients treated with vancomycin for staphylococcal infection, 29.5% were rehospitalised within 6 months of discharge compared with 17.9% of those who were treated with linezolid.

Of patients treated with vancomycin for skin and soft-tissue infections, 29.1% were rehospitalised within 6 months of discharge compared with 22.5% of those who were treated in the hospital with linezolid.

All of the differences achieved statistical significance (P < .001).

Dr. Mullins explained that doctors could prevent 1 pneumonia readmission by treating 17 patients with linezolid instead of vancomycin. The number to treat to prevent 1 staphylococcal infection was 9 patients, he said. The number to treat to avoid 1 skin and soft-tissue infection was 16. "These are very small numbers," Dr. Mullins added.

Although the researchers attempted to control for many variables, Dr. Mullins said that confounding by indication could have biased the results. "Our results should be confirmed by a future prospective clinical trial," he noted.

Funding for this study was provided by Pfizer, Inc.

[Presentation title: Linezolid vs Vancomycin: Re-Hospitalization Rates Among Patients With Pneumonia, Staphylococcal Infection, and Skin and Soft Tissue Infection. Abstract 493]

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