comparative evaluation of linezolid and teicoplanin in the treatment of ventilator-associated mrsa pneumonia: a single-center experience

Background: ventilator-associated pneumonia (vap) caused by methicillin-resistant staphylococcus aureus (mrsa) is a serious infection in an intensive care unit (icu). ventilator-associated mrsa pneumonia (vamp) in critically ill patients causes a high rate of mortality. objectives: this study mainly aimed to compare the clinical outcomes and associated drug safety perspective of linezolid and teicoplanin in vamp treatment. methods: this retrospective study included 98 adult icu patients with vamp, where 42 patients (lzd group) and 56 patients (tpn group) received a standard dose of linezolid and teicoplanin, respectively, for their vamp treatment. adverse reactions associated with linezolid and teicoplanin were considered. clinical outcomes and 30-day mortality rates were compared in both groups. results: the lzd group showed a higher mrsa eradication rate (97%, n = 34) than the tpn group (94.3%, n = 53) (p = 0.034). the linezolid and teicoplanin therapy was suddenly discontinued in 19% and 5.3% of the patients in the lzd and tpn groups, respectively, before completing the full duration of antibiotic therapy due to developed adverse drug reactions (adrs), including thrombocytopenia (lzd/tpn groups: 7/1 event), tachycardia (lzd group: 1 event), and nephrotoxicity (tpn group: 2 events). this discontinuation increased the total duration of antibiotic therapy in 19% (n = 42) and 5.3% (n = 56) of the patients (p = 0.034) in the lzd and tpn groups, respectively. conclusions: vamp is a life-threatening event in critically ill icu patients worldwide. in this study, teicoplanin showed better clinical outcomes with a certain higher level of drug safety compared to linezolid in the treatment of ventilator-associated mrsa pneumonia.