Abstract

The latest published Linezolid in the treatment of subjects with nosocomial pneumonia proven to be due to methicillin-resistant Staphylococcus aureus (ZEPhyR) trial was a phase IV, randomized, double-blind, multicenter, comparator-controlled study comparing the efficacy of fixed-dose linezolid to dose-optimized vancomycin in hospitalized adults for the treatment of methicillin-resistant S. aureus (MRSA) nosocomial pneumonia. They found out that the superiority of linezolid over vancomycin was with regard to both clinical responses and microbiological outcomes but without a survival advantage. However, the study had a number of shortcomings: failing to implement the guideline about vancomycin doing and goal trough level, recruitment of health care-associated pneumonia (HCAP) population, failing to explain mortality rate in different minimal inhibitory concentration (MIC) subgroups and glomerular filtration rates (GFR) subgroups etc. Limitations of the study made us consider routine use of linezolid for the treatment of MRSA pneumonia with prudence.

Key words: Nosocomial pneumonia (NP), trough level, ventilator-associated pneumonia (VAP), health care-associated pneumonia (HCAP), methicillin-resistant S. aureus (MRSA).