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在ATSIC会议上（American Thoracic Society International Conference）
Shorr AF。报道了他们研究团队的结果。【Andrew F. Shorr, MD, MPH, associate director of pulmonary and critical care medicine at the Washington Hospital Center in Washington, D.C. 】
他们发现,从临床微生物培养的角度，对于MRSA VAP的患者，对于与万古霉素，应用利奈唑胺有更好的临床预后。
在治疗组，利奈唑胺可以更好的临床成功率（对比与万古霉素）。
主要比较指标：clinical success rate ，临床成功率。
Linezolid was associated with better outcomes in patients with methicillin-resistant Staphylococcus aureus ventilator-associated pneumonia vs. those assigned vancomycin, according to new findings presented at the American Thoracic Society International Conference.
“At the end of the treatment period, linezolid offered statistically significant higher rates of clinical and microbiologic success in patients with MRSA ventilator-associated pneumonia (VAP) than weight-based vancomycin dosing, suggesting that in severely ill patients with MRSA VAP, linezolid performs well and is well tolerated,”
Shorr and colleagues randomly assigned 286 patients included in a larger clinical trial that assessed MRSA nosocomial pneumonia to twice-daily 15 mg vancomycin (n=147) or twice-daily 600 mg linezolid (n=139). Researchers defined VAP as clinical signs and symptoms of pneumonia and/or evolving X-ray results among those who underwent at least 2 days of mechanical ventilation.
Clinical and microbiologic successes were also measured at the end of treatment (approximately 10 days after enrollment) and at study end (approximately 28 days after enrollment.) （在进入研究的10天和28天分别进行临床微生物的培养检验）
At follow-up, researchers observed a clinical success rate of 78.6% among those assigned linezolid compared with 65.9% among those assigned vancomycin. （经过随访，研究者发现，利奈唑胺的临床成功率要高于万古霉素：78.6% vs. 65.9%)
Moreover, treatment with linezolid was associated with a clinical success rate of 52.1% vs. 43.4% with vancomycin. Microbiological success rates were 76.6% with linezolid vs. 57.7% with vancomycin by the end of treatment; and 56.2% with linezolid vs. 47.1% with vancomycin at study end.
Similar adverse events and mortality rates were observed for both treatment arms.
“Cure rates at the time of finishing treatment were higher in persons treated with linezolid as opposed to vancomycin,” Shorr said. “The difference in cure rates still favored linezolid at the end of the study, but the difference was not statistically significant. There was no difference in mortality between the two treatments and both appeared well tolerated. Our data also suggest that we remain uncertain how to optimally dose vancomycin for pneumonia.”
【Disclosure】 Dr. Shorr reports no relevant financial disclosures.
文章在最后总结了，治愈率在两组之间无差别，随访发现死亡率也无显著性水准。所以目前还不能说明利奈唑胺的效果一定优于万古霉素。
可能需要进一步的临床验证。
注：这篇文章仅仅是会议交流，没有通过peer-review,所以也只有一定的参考价值，还不能作为临床偱证指南。 |
发表于 2011-5-19 22:56
新闻速递，看看无妨。
发表于 2011-5-20 06:48