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首页> 外文期刊>Medecine et maladies infectieuses >The ZEPHyR study: A randomized comparison of linezolid and vancomycin for MRSA pneumonia
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The ZEPHyR study: A randomized comparison of linezolid and vancomycin for MRSA pneumonia

机译：ZEPHyR研究：利奈唑胺和万古霉素治疗MRSA肺炎的随机比较

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) accounts for 10-40% of hospital-acquired pneumonia, and even more in intensive care units. The current guidelines for the treatment of MRSA nosocomial pneumonia include vancomycin and linezolid. The authors of 2 prospective randomized trials comparing vancomycin and linezolid in nosocomial pneumonia had concluded to the non-inferiority of linezolid. A slight superiority of linezolid was observed in the MRSA pneumonia subgroup, in terms of clinical success and survival, but no definite conclusion could be drawn. Methods: A prospective randomized study was made to compare a fixed linezolid dose to dose-optimized vancomycin for the treatment of bacteriologically proven MRSA nosocomial pneumonia (ZEPHyR Study). Results: Among the 165 patients treated by linezolid (57.6%) in the PP population, 95 were clinically cured at the end of the study, compared to 81 of the 174 patients treated by vancomycin (46.6%) (IC 95% of the difference 0.5%-21.6%, P= 0.042). Nephrotoxicity in the mITT population reached 8.4% in the linezolid group compared to 18.2% in the vancomycin group. Conclusion: LNZ was superior to vancomycin for the treatment of MRSA nosocomial pneumonia.
机译：背景：耐甲氧西林的金黄色葡萄球菌（MRSA）占医院获得性肺炎的10-40％，在重症监护病房中甚至更高。目前治疗MRSA医院肺炎的指南包括万古霉素和利奈唑胺。两项比较万古霉素和利奈唑胺在医院内肺炎中的前瞻性随机试验的作者得出结论，利奈唑胺的疗效不逊色。在临床成功率和存活率方面，在MRSA肺炎亚组中观察到了利奈唑胺的轻微优势，但尚不能得出明确的结论。方法：进行一项前瞻性随机研究，比较固定的利奈唑胺剂量和最佳剂量的万古霉素治疗经细菌学证实的MRSA医院内肺炎（ZEPHyR研究）。结果：PP人群中利奈唑胺治疗的165例患者（占57.6％）在研究结束时有95例临床治愈，而万古霉素治疗的174例患者中有81例（46.6％）（IC差异为95％） 0.5％-21.6％，P = 0.042）。利奈唑胺组mITT人群的肾毒性达到8.4％，而万古霉素组为18.2％。结论：LNZ治疗MRSA院内肺炎优于万古霉素。

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