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. 2022 May 26;17(1):969-977.
doi: 10.1515/med-2022-0440. eCollection 2022.

Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis

Qian Wu  1 , Xiaohua Xu  1 , Mingqing Tian  1 , Jianyang Jiang  1
Affiliations

Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis

Qian Wu et al. Open Med (Wars). .

Abstract

Both linezolid and vancomycin have good efficacy in the treatment of resistant Gram-positive bacterial infections. This systematic review and meta-analysis aimed to compare the efficacy and safety of linezolid vs vancomycin for the treatment of resistant Gram-positive bacterial infections in children under 12 years. Five randomly controlled trials involving 638 children that were treated with linezolid and vancomycin for resistant Gram-positive bacterial infections were searched from medical databases. Meta-analysis showed that linezolid and vancomycin had equivalent efficacies in clinical cure rates in the intent-to-treat population (95% confidence interval [CI] 0.88, 2.09) and microbiologically evaluable patients (95% CI: 0.46, 2.47). Linezolid and vancomycin also had equivalent pathogen eradication rates for Staphylococcus aureus (95% CI: 0.31, 4.81), methicillin-resistant S. aureus (95% CI: 0.36, 5.34), Enterococcus faecalis (95% CI: 0.32, 8.76), and coagulase-negative Staphylococci (95% CI: 0.43, 4.01). Vancomycin resulted in a higher incidence of alanine aminotransferase increase (95% CI: 0.37, 0.97), red man syndrome (95% CI: 0.01, 0.28), and rash (95% CI: 0.11, 0.73) than linezolid. Clinically, linezolid had a superior safety to vancomycin for resistant Gram-positive infections. Linezolid might be prescribed for the treatment of resistant Gram-positive bacterial infections in children under 12 years.

Keywords: Gram-positive bacterial infections; linezolid; methicillin-resistant Staphylococcus aureus; pediatrics; pneumonia; vancomycin.

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Conflict of interest statement

Conflict of interest: The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
The flow diagram of study selection processing.
Figure 2
Figure 2
The forest plot of the clinical cure rate of linezolid vs vancomycin in children (<12 years) with resistant Gram-positive bacterial infections. (a) and (b) The comparative overall clinical cure rate and clinical cure rates in microbiologically evaluable patients treated with linezolid vs vancomycin in the treatment of resistant Gram-positive bacterial infections in children under 12 years. M-H, Mantel-Haenszel; CI, confidential interval.
Figure 3
Figure 3
Pathogen eradication rate of linezolid vs. vancomycin in children (<12 years) with resistant Gram-positive bacterial infections. Pathogen eradication rate for S. aureus, MRSA, Enterococcus faecalis, and CoNS in microbiologically evaluable patients treated with linezolid vs vancomycin for the treatment of resistant Gram-positive bacterial infections in children under 12 years. M-H, Mantel-Haenszel; CI, confidential interval.
Figure 4
Figure 4
Total adverse event rate by linezolid vs. vancomycin in the treatment of resistant Gram-positive bacterial infections in children <12 years. M-H, Mantel-Haenszel; CI, confidential interval.
See this image and copyright information in PMC

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