Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of
ventilator-associated pneumonia (VAP), especially in patients who develop VAP late in their hospital course. Clinical failure in MRSA VAP is unacceptably high.
Linezolid is an
oxazolidinone antimicrobial agent that demonstrates bacteriostatic activity against MRSA and has been demonstrated to be equivalent to
vancomycin in the treatment of
nosocomial pneumonia. Retrospective analysis of two randomized, double-blind, studies suggests that
linezolid therapy may confer clinical benefit over
vancomycin in patients with MRSA VAP.
Linezolid demonstrates excellent penetration into the epithelial-lining fluid and this feature has been postulated to be integral to its therapeutic benefit in MRSA VAP. This article evaluates the findings of a recently published prospective, randomized, open-label, comparator-controlled, multicenter trial that aims to compare the early microbiological efficacy of
linezolid with
vancomycin in the treatment of VAP caused by MRSA.