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Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children.
Pediatr Infect Dis J 2003; 22(9 Suppl):S178-85PI

Abstract

BACKGROUND

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are becoming increasingly prevalent. Linezolid is effective and well-tolerated in the treatment of adults with MRSA infections.

OBJECTIVE

To evaluate the clinical efficacy and safety of iv/oral linezolid in children with MRSA infections.

METHODS

Data were obtained from two independent clinical trials. In an outpatient trial children (5 to 17 years of age) with uncomplicated skin and skin structure infections (SSSIs) were treated with linezolid or cefadroxil. In an inpatient trial hospitalized children (0 to 11 years of age) with pneumonia, bacteremia or complicated SSSI caused by resistant Gram-positive pathogens were administered iv linezolid with the option to switch to oral suspension (patients >90 days of age) or iv vancomycin. A subset of patients with MRSA infections from the two clinical trials is analyzed herein.

RESULTS

In the outpatient trial children with skin infections caused by MRSA were treated with linezolid (15 patients) and cefadroxil (10 patients). In the microbiologically evaluable population, the clinical cure rate was 92.3% in the linezolid group and 85.7% in the cefadroxil group (P = 0.64). The pathogen eradication rate for MRSA was 92.3 and 85.7% in the linezolid and cefadroxil groups, respectively (P = 0.64). There were very few adverse events or drug-related adverse events and no serious adverse events in the outpatient trial. In the inpatient trial 20 children treated with linezolid and 14 treated with vancomycin had infections caused by MRSA. In the microbiologically evaluable population, the clinical cure rate was 94.1% in the linezolid group and 90.0% in the vancomycin group (P = 0.69). Pathogen eradication rates were 88.2 and 90.0% for the linezolid and vancomycin groups, respectively (P = 0.89). Susceptibility patterns of the MRSA isolates showed distinct patterns between the outpatient and inpatient trials. In the inpatient trial fewer patients in the linezolid group had drug-related adverse events than did those in the vancomycin group (20% vs. 43%; P = 0.15).

CONCLUSIONS

Intravenous/oral linezolid is effective and well-tolerated in children with MRSA infections.

Authors+Show Affiliations

Texas Children's Hospital MC 3-2371, 6621 Fannin Street, Suite 1150, Houston, TX 77030, USA. skaplan@bcm.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Clinical Trial, Phase III
Controlled Clinical Trial
Journal Article
Meta-Analysis
Multicenter Study

Language

eng

PubMed ID

14520144

Citation

Kaplan, Sheldon L., et al. "Linezolid for the Treatment of Methicillin-resistant Staphylococcus Aureus Infections in Children." The Pediatric Infectious Disease Journal, vol. 22, no. 9 Suppl, 2003, pp. S178-85.
Kaplan SL, Afghani B, Lopez P, et al. Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatr Infect Dis J. 2003;22(9 Suppl):S178-85.
Kaplan, S. L., Afghani, B., Lopez, P., Wu, E., Fleishaker, D., Edge-Padbury, B., ... Bruss, J. B. (2003). Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children. The Pediatric Infectious Disease Journal, 22(9 Suppl), pp. S178-85.
Kaplan SL, et al. Linezolid for the Treatment of Methicillin-resistant Staphylococcus Aureus Infections in Children. Pediatr Infect Dis J. 2003;22(9 Suppl):S178-85. PubMed PMID: 14520144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections in children. AU - Kaplan,Sheldon L, AU - Afghani,Behnoosh, AU - Lopez,Pio, AU - Wu,Elba, AU - Fleishaker,Dona, AU - Edge-Padbury,Barbara, AU - Naberhuis-Stehouwer,Sharon, AU - Bruss,Jon B, PY - 2003/10/2/pubmed PY - 2003/11/13/medline PY - 2003/10/2/entrez SP - S178 EP - 85 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 22 IS - 9 Suppl N2 - BACKGROUND: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are becoming increasingly prevalent. Linezolid is effective and well-tolerated in the treatment of adults with MRSA infections. OBJECTIVE: To evaluate the clinical efficacy and safety of iv/oral linezolid in children with MRSA infections. METHODS: Data were obtained from two independent clinical trials. In an outpatient trial children (5 to 17 years of age) with uncomplicated skin and skin structure infections (SSSIs) were treated with linezolid or cefadroxil. In an inpatient trial hospitalized children (0 to 11 years of age) with pneumonia, bacteremia or complicated SSSI caused by resistant Gram-positive pathogens were administered iv linezolid with the option to switch to oral suspension (patients >90 days of age) or iv vancomycin. A subset of patients with MRSA infections from the two clinical trials is analyzed herein. RESULTS: In the outpatient trial children with skin infections caused by MRSA were treated with linezolid (15 patients) and cefadroxil (10 patients). In the microbiologically evaluable population, the clinical cure rate was 92.3% in the linezolid group and 85.7% in the cefadroxil group (P = 0.64). The pathogen eradication rate for MRSA was 92.3 and 85.7% in the linezolid and cefadroxil groups, respectively (P = 0.64). There were very few adverse events or drug-related adverse events and no serious adverse events in the outpatient trial. In the inpatient trial 20 children treated with linezolid and 14 treated with vancomycin had infections caused by MRSA. In the microbiologically evaluable population, the clinical cure rate was 94.1% in the linezolid group and 90.0% in the vancomycin group (P = 0.69). Pathogen eradication rates were 88.2 and 90.0% for the linezolid and vancomycin groups, respectively (P = 0.89). Susceptibility patterns of the MRSA isolates showed distinct patterns between the outpatient and inpatient trials. In the inpatient trial fewer patients in the linezolid group had drug-related adverse events than did those in the vancomycin group (20% vs. 43%; P = 0.15). CONCLUSIONS: Intravenous/oral linezolid is effective and well-tolerated in children with MRSA infections. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/14520144/Linezolid_for_the_treatment_of_methicillin_resistant_Staphylococcus_aureus_infections_in_children_ L2 - http://dx.doi.org/10.1097/01.inf.0000087020.75886.93 DB - PRIME DP - Unbound Medicine ER -