政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/75547
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    题名: Daptomycin versus linezolid for treatment of vancomycin-resistant enterococcal bacteremia: Systematic review and meta-analysis
    作者: Lin, Hsin-Yi
    林馨怡
    Wang, J.-T.
    Chuang, Y.-C.
    贡献者: 經濟系
    关键词: Daptomycin;Linezolid;Meta-analysis;Vancomycin-resistant enterococci
    日期: 2014-12
    上传时间: 2015-06-03 12:32:44 (UTC+8)
    摘要: Linezolid, which has bacteriostatic activity, is approved for the treatment of vancomycin-resistant enterococci (VRE) infections. Meanwhile, daptomycin exerts bactericidal activity against VRE, but is not approved for the treatment of VRE bacteremia. Only a few studies with small sample sizes have compared the effectiveness of these drugs for treatment of VRE bacteremia. Methods: PubMed, EMBASE, and the Cochrane Library were searched for studies of VRE bacteremia treatment published before January 1, 2014. All studies reporting daptomycin and linezolid treatment outcomes simultaneously were included. The endpoints were mortality and microbiological cure. The adjusted odds ratios (aORs) of mortality in daptomycin- and linezolid-treated patients were extracted if available. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for all outcomes using a random-effects model. Results: Thirteen studies (532 patients receiving daptomycin, 656 patients receiving linezolid) met the selection criteria. All studies had retrospective cohort designs and relatively small sample sizes. Eight studies compared the aORs of mortality in daptomycin- and linezolid-treated patients. Four studies were published as conference papers and there was significant heterogeneity among these studies ((I2 = 63%, p = 0.04). Daptomycin use was not associated with better microbiological cure (daptomycin. linezolid, OR: 0.67, 95% CI: 0.42-1.06, 0.09). However, mortality was higher in patients receiving daptomycin (OR: 1.43, 95% CI: 1.09-1.86, 0.009). Subgroup analysis of studies that reported aORs indicated that daptomycin was associated with higher mortality (OR: 1.59, 95% CI: 1.02-2.50, 0.04). There was no evidence of publication bias, but all enrolled studies were retrospective, had small sample sizes, and had substantial limitations. Conclusions: Although limited data is available, the current meta-analysis shows that linezolid treatment for VRE bacteremia was associated with a lower mortality than daptomycin treatment. However, the results should be interpreted cautiously because of limitations inherent to retrospective studies and the high heterogeneity among studies. A large randomized trial is needed to confirm the present results.
    關聯: BMC Infectious Diseases, 14(1), 650-669, 論文編號 687
    数据类型: article
    DOI 連結: http://dx.doi.org/10.1186/s12879-014-0687-9
    DOI: 10.1186/s12879-014-0687-9
    显示于类别:[資訊科學系] 期刊論文

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