Vol.59 No.6 November 2011
Treatment strategy aimed towards for the short-term use of linezolid in severe and refractory infections with methicillin-resistant Staphylococcus aureus
1)Department of Infection Control and Prevention, The Hospital of Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, Japan
2)Department of Pharmacy, The Hospital of Hyogo College of Medicine
Abstract
Purpose: The restricted use of linezolid(LZD) is mandatory to prevent adverse effects and occurrence of resistance. The aim of the present study was to investigate the efficiency of a treatment strategy aimed at short-term LZD use in patients with methicillin-resistant Staphylococcus aureus(MRSA) infections.
Methods: This study was conducted between July 2007 and June 2009. The strategy was referred to as a scheduled sequential therapy(SST) consisted of step down therapy(SD) in severe infections and LZD use restricted to the peri-operative period in refractory infections (use restricted to the peri-operative period; URPOP).
Results: Seventy patients undergoing SST (28 patients for SD, 44 patients for URPOP, 2 patients were overlapped) were examined. The duration of LZD was 7.8±5.4 days in patients undergoing SST. The efficacy during the course of SST was 58/70 patients (82.9%) (SD 71.4%, URPOP 90.9%). The efficacy during LZD administration was 95.7% (SD 100%, URPOP 93.2%). The occurrence of thrombocytopenia in SST was 28.6% (SD 35.7%, URPOP 25.0%) and tended to be lower compared with that in LZD use for patients who did not undergo SST (p=0.051).
Conclusions: With SST, the duration of LZD use was about 8 days in patients with severe/refractory MRSA infections, and the implementation of SST was not only associated with a low incidence of thrombocytopenia but also showed a high efficacy rate.
Key word
linezolid, MRSA, sepsis, thrombocytopenia
Received
April 12, 2011
Accepted
July 22, 2011
Jpn. J. Chemother. 59 (6): 580-584, 2011
