https://scholars.lib.ntu.edu.tw/handle/123456789/535159
標題: | Daptomycin versus linezolid for treatment of vancomycin-resistant enterococcal bacteremia: Systematic review and meta-analysis | 作者: | YU-CHUNG CHUANG JANN-TAY WANG Lin H.-Y. SHAN-CHWEN CHANG |
公開日期: | 2014 | 出版社: | BioMed Central Ltd. | 卷: | 14 | 期: | 1 | 起(迄)頁: | 687 | 來源出版物: | BMC Infectious Diseases | 摘要: | Linezolid, which has bacteriostatic activity, is approved for the treatment of vancomycin-resistant enterococci (VRE) infections. Meanwhile, daptomycin exerts bactericidal activity against VRE, but is not approved for the treatment of VRE bacteremia. Only a few studies with small sample sizes have compared the effectiveness of these drugs for treatment of VRE bacteremia. Methods: PubMed, EMBASE, and the Cochrane Library were searched for studies of VRE bacteremia treatment published before January 1, 2014. All studies reporting daptomycin and linezolid treatment outcomes simultaneously were included. The endpoints were mortality and microbiological cure. The adjusted odds ratios (aORs) of mortality in daptomycin- and linezolid-treated patients were extracted if available. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for all outcomes using a random-effects model. Results: Thirteen studies (532 patients receiving daptomycin, 656 patients receiving linezolid) met the selection criteria. All studies had retrospective cohort designs and relatively small sample sizes. Eight studies compared the aORs of mortality in daptomycin- and linezolid-treated patients. Four studies were published as conference papers and there was significant heterogeneity among these studies ((I2 = 63%, p = 0.04). Daptomycin use was not associated with better microbiological cure (daptomycin. linezolid, OR: 0.67, 95% CI: 0.42-1.06, 0.09). However, mortality was higher in patients receiving daptomycin (OR: 1.43, 95% CI: 1.09-1.86, 0.009). Subgroup analysis of studies that reported aORs indicated that daptomycin was associated with higher mortality (OR: 1.59, 95% CI: 1.02-2.50, 0.04). There was no evidence of publication bias, but all enrolled studies were retrospective, had small sample sizes, and had substantial limitations. Conclusions: Although limited data is available, the current meta-analysis shows that linezolid treatment for VRE bacteremia was associated with a lower mortality than daptomycin treatment. However, the results should be interpreted cautiously because of limitations inherent to retrospective studies and the high heterogeneity among studies. A large randomized trial is needed to confirm the present results. ? 2014 Chuang et al.; licensee BioMed Central. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84924036447&doi=10.1186%2fs12879-014-0687-9&partnerID=40&md5=ddb4d87077cb05ab0c78192d45909399 https://scholars.lib.ntu.edu.tw/handle/123456789/535159 |
ISSN: | 1471-2334 | DOI: | 10.1186/s12879-014-0687-9 | SDG/關鍵字: | creatine kinase; daptomycin; linezolid; acetamide derivative; antiinfective agent; daptomycin; linezolid; oxazolidinone derivative; vancomycin; acute kidney failure; Article; bactericidal activity; comparative effectiveness; drug efficacy; enterococcal infection; human; hypertransaminasemia; meta analysis; mortality; recurrence risk; retrospective study; systematic review; thrombocytopenia; treatment outcome; vancomycin resistant enterococcal bacteremia; antibiotic resistance; bacteremia; comparative study; drug effects; microbiology; vancomycin resistant Enterococcus; Acetamides; Anti-Bacterial Agents; Bacteremia; Daptomycin; Humans; Linezolid; Oxazolidinones; Retrospective Studies; Treatment Outcome; Vancomycin; Vancomycin Resistance; Vancomycin-Resistant Enterococci |
顯示於: | 醫學系 |
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