Linezolid vs. Vancomycin for MRSA

Although linezolid is effective against mild-to-moderate MRSA infection, routine use for this purpose should be avoided to avert emergence of linezolid-resistant VRE.

Vancomycin has been the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections. This agent, however, requires intravenous (IV) administration, and occasionally patients experience unacceptable side effects. Linezolid, a member of the new oxazolidone class of antibiotics, is highly active in vitro against MRSA and has excellent oral bioavailability. Cumulative data indicate that linezolid and vancomycin have similar clinical efficacy against MRSA infections. In a 140-site international trial sponsored by linezolid's manufacturer, patients with presumed MRSA infections (2/3 culture-confirmed) requiring hospitalization received either IV vancomycin (1g twice daily; 220 patients) or linezolid (600 mg twice daily; …

Reviewing Author

Bradley E. Britigan, MD