Clinical outcomes of linezolid and vancomycin in patients with nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus stratified by baseline renal function: a retrospective, cohort analysis

BMC Nephrology
Ping LiuAli A El-Solh

Abstract

The primary objective of this study is to assess whether baseline renal function impacts treatment outcomes of linezolid and vancomycin (with a dose-optimized regimen) for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. We conducted a retrospective cohort analysis of data generated from a prospective, randomized, controlled clinical trial (NCT 00084266). The analysis included 405 patients with culture-proven MRSA pneumonia. Baseline renal function was stratified based on creatinine clearance. Clinical and microbiological success rates and presence of nephrotoxicity were assessed at the end of treatment (EOT) and end of study (EOS). Multivariate logistic regression analyses of baseline patient characteristics, including treatment, were performed to identify independent predictors of efficacy. Vancomycin concentrations were analyzed using a nonlinear mixed-effects modeling approach. The relationships between vancomycin exposures, pharmacokinetic-pharmacodynamic index (trough concentration, area under the curve over a 24-h interval [AUC0-24], and AUC0-24/MIC) and efficacy/nephrotoxicity were assessed in MRSA pneumonia patients using univariate logistic regression or Cox proportional hazards regression analysis approa...Continue Reading

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Citations

May 18, 2020·The Journal of Antimicrobial Chemotherapy·Ioannis BellosVasilios Pergialiotis
Jul 15, 2020·Antibiotics·Iris H Chen, David P Nicolau
Mar 7, 2021·The Journal of Antimicrobial Chemotherapy·Sarah C J JorgensenBruce R Dalton
Nov 23, 2019·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·B R DaltonE Rennert-May

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Methods Mentioned

BETA
X-ray
bronchoalveolar lavage

Software Mentioned

NONMEM
SAS
R

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