Objective: This study aims to systematically compare the efficacy and safety of linezolid andvancomycinfor treatment of hospital-acquired pneumonia (HAP).
Methods: PubMed, EMbase, MEDLINE, The Cochrane Library, CNKI, VIP, and Wan Fang databases were searched. Relevant conference proceedings in Chinese or English were manually searched. Randomized controlled trials (RCTs) were included in this study. RevMan 5.2 software was applied to do Meta-analysis.
Results: Totally 6088 patients with HAP in 7 RCTs were included. The meta-analysis results showed that the response rates between Linezolid and Vancomycin had no significant difference [OR=1.11, 95% CI (0.98, 1.17), P=0.10]. As to pathogen eradication, the efficacy of linezolid or vancomycin had no significant difference [OR=1.16, 95% CI (0.97, 1.40), P=0.10]. The exit event rate in trials induced by linezolid or vancomycin had no significant difference (P=0.40), and the incidence of gastrointestinal adverse events by linezolid or vancomycin was also not significantly different (P=0.18). The risk of renal dysfunction was significantly higher in vancomycin group than in linezolid group [OR=0.51, 95% CI (0.36, 0.73), P=0.0002], while the thrombocytopenia was significantly higher in linezolid group than in vancomycin group [OR=1.27, 95% CI (1.03, 1.57), P=0.02].
Conclusion: The efficacy of linezolid and vancomycin was similar for treatment of HAP. The risk dysfunction induced by linezolid was significantly lower than that byvancomycin, while the thrombocytopenia caused by linezolid was significantly higher than that by vancomycin.