Title: Clinical and economic outcomes of oral linezolid versus intravenous vancomycin in the treatment of MRSA-complicated, lower-extremity skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus
Authors: J. Neal Sharpe, MD, Eugene H. Shively, MD, Hiram C. Polk Jr., MD
Source: The American Journal of Surgery April 2005, Vol. 189 #4 PP. 425-428
PODIATRIC RELEVANCE:
Lower extremity wounds are a problem faced by Podiatrists on a daily basis. Whether the wounds are due to complication of diabetes, trauma, neglect, etc, chances are that some or most of the wounds will become contaminated or infected. With the rise of resistant strains of bacteria, infections could become complicated and difficult to treat. The numbers of methicillin-resistant Stphylococcus aureus (MRSA) contaminations and infections are on the rise and is a major problem in hospitals both in cost as well as containment. Methods of treatment are limited; this article compares the two commonly used antibiotics in MRSA infections.
METHODS:
A randomized study with 60 patients aged 18 years or older with MRSA proven skin and soft tissue infections requiring surgical intervention. Separated into two groups with 30 patients in each group, one group received oral linezolid and the other group received intravenous vancomycin for 7-21 days. At the end of study, Clinical results and duration of hospital stay were reviewed.
RESULTS:
In comparing vancomycin and linezolid, linezolid was found to have greater rates of clinical cure and improvement, a 3 days shorter stay in the hospital, and lowered outpatient charges. The group of patients who received vancomycin had more treatment failures and subsequent amputations.
COMMENTS:
As doctors and experts of the lower extremities, we should be aware of all the options available and the best option among them. Even though vancomycin is still most commonly used antibiotic for MRSA infections, the patient is required to stay in hospital or subacute facility or visiting nurse to maintain a intravenous access. With the rise of health care cost, this finding that linezolid will allow the patient to leave the hospital 3 days earlier would help control the cost of the hospital stay.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.