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Effectiveness of linezolid in nosocomial and severe community-acquired pneumonia: meta-analysis

Abstract number: 1733_341

Yeniova O., Ascioglu S.

Objective: To review the evidence for the effectiveness of linezolid treatment in patients with nosocomial or severe community acquired pneumonia (CAP).

Methods: We searched PubMed and Cochrane databases (January 1990 to 31 October 2006) using linezolid and pneumonia as text words, also hand searched the bibliographies of published studies. We tried to be inclusive in our inclusion criteria due to scarcity of studies in this area. Studies met our inclusion criteria if they were randomised controlled trials or observational studies comparing linezolid with a suitable comparator in adult patients with pneumonia. Pooled estimates of the risk ratio (RR) for successful outcome were obtained using a fixed effects model. Test of heterogeneity was not significant (MH test, p = 0.950).

Results: Our search yielded a total of 117 references. After we examined all abstracts, we identified 6 randomised controlled trials. There weren't any observational studies or non-randomised trials which met our inclusion criteria. Only 2 of the included trials had a primary objective of evaluating effectiveness in nosocomial pneumonia patients, 3 trials had subgroups of nosocomial pneumonia patients and 1 trial included hospitalised patients with severe CAP. In all but 1 of the studies comparator drug was a glycopeptide (2 studies teicoplanin, 3 vancomycin), in the severe CAP study only, comparator drug was ceftriaxone. The pooled analysis of all trials showed that linezolid was not associated with a significantly better outcome than the comparator treatments (RR: 1.05, 95% CI: 0.98–1.12) (Figure). We did a sensitivity analysis including only nosocomial pneumonia studies; omission of the CAP study which appeared to be the one that dominated the other trials attenuated the effect estimate (RR: 1.02, 95% CI: 0.92–1.13). Our sample size was too small to evaluate publication bias.

Conclusions: Linezolid had a very small favourable effect on the outcome of patients with severe CAP and nosocomial pneumonia and this result wasn't statistically significant. Future trials addressing linezolid treatment in these patient groups are urgently needed.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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