Abstract | BACKGROUND: MATERIALS AND METHODS: Patients received up to four weeks of linezolid (intravenous followed by optional oral) or vancomycin (intravenous only), followed by up to four weeks of observation. Unadjusted LOS was estimated using Kaplan-Meier survival functions, whereas the log-logistic survival analysis model was used to estimate the multivariate-adjusted LOS controlling for patient demographics and selected baseline clinical variables. Analysis was done on the intent-to-treat (n = 230) sample as well as on two subsamples of the clinically evaluable (n = 144) and surgical site infection (n = 114) patients. RESULTS: The unadjusted Kaplan-Meier median LOS was five days shorter for the linezolid group than the vancomycin group in the intent-to-treat sample (9 vs. 14 days, p = 0.052). It was eight days shorter (8 vs. 16 days, p = 0.0025) in the clinically evaluable sample, but the difference in the surgical site infection sample was not significant (10 vs. 14 days; p = 0.29). The linezolid group's unadjusted mean LOS was 1.7, 5.3 and 0.8 days shorter in the intentto-treat, clinically evaluable, and surgical site infection samples, respectively. After adjusting for age, gender, race, geographic region, bacteremia, type of inpatient location, and number of concurrent medical conditions using the log-logistic model, between-treatment differences in the multivariate-adjusted median LOS decreased to 3, 6, and 3 days, whereas the differences in mean LOS increased to 3.1, 6.5 and 2.5 days for the intent-to-treat, clinically evaluable, and surgical site infection samples (p < 0.01, < 0.01, and < 0.10), respectively. When the between-treatment differences in LOS were expressed as odds ratio of hospital discharges, multivariate-adjustment increased the odds ratios in favor of linezolid for all the three samples. CONCLUSION: Results from this randomized trial show that linezolid can significantly reduce LOS for patients with complicated skin and soft tissue infections from suspected or confirmed methicillin-resistant staphylococci.
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Authors | Jim Zhiming Li, Richard J Willke, Brian E Rittenhouse, Michael J Rybak |
Journal | Surgical infections
(Surg Infect (Larchmt))
Vol. 4
Issue 1
Pg. 57-70
( 2003)
ISSN: 1096-2964 [Print] United States |
PMID | 12744768
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Acetamides
- Anti-Bacterial Agents
- Oxazolidinones
- Vancomycin
- Linezolid
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Topics |
- Acetamides
(administration & dosage)
- Administration, Oral
- Aged
- Anti-Bacterial Agents
(pharmacology)
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Female
- Humans
- Length of Stay
- Linezolid
- Male
- Methicillin Resistance
- Microbial Sensitivity Tests
- Middle Aged
- Oxazolidinones
(administration & dosage)
- Probability
- Prognosis
- Severity of Illness Index
- Skin Diseases, Bacterial
(drug therapy, microbiology)
- Staphylococcus aureus
(drug effects, isolation & purification)
- Treatment Outcome
- Vancomycin
(administration & dosage)
- Wound Infection
(drug therapy, microbiology)
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