Observational studyBMC infectious diseases2025
Vancomycin versus linezolid for treatment of staphylococcal-associated central nervous system infections.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative effectiveness and safety of vancomycin versus linezolid for the treatment of central nervous system infections: a meta-analysis.Frontiers in cellular and infection microbiology · 2025Pooled it
- [From cutaneous abscess to ventriculitis caused by Panton-Valentine leukocidin-positive methicillin-resistantRevista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Article
- Successful Management of Infective Endocarditis Utilizing Rapid High-performance Liquid Chromatography-based Therapeutic Drug Monitoring: Balancing Linezolid Efficacy and Thrombocytopenia Risk.Internal medicine (Tokyo, Japan) · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLinezolid and vancomycin are both recommended for the treatment of staphylococcal-associated central nervous system (CNS) infections. However, to date, no data are available comparing the outcomes of patients treated with vancomycin or linezolid for these infections. The aim of this study was to compare the incidence of treatment failure and adverse events (AEs) associated with vancomycin and linezolid in staphylococcal-associated CNS infections.
methodsThis retrospective monocentric observational study was conducted between 01/01/2015 and 31/12/2023. All patients with a confirmed staphylococcal associated CNS infection and treated with vancomycin or linezolid were included. Failure of antimicrobial treatment was the primary outcome of interest, defined by a composite criteria: persistence of infection (i.e. positive culture after > 72 h of antimicrobial treatment active on the isolated bacteria), relapse of infection (i.e. new infection with the same bacteria involved in the initial episode) or infection related death. Second outcome of interest was AE incidence related to linezolid or vancomycin. Outcomes were analysed using survival analysis techniques and propensity score.
resultsNinety one patients were included: 51 in vancomycin group and 40 in linezolid group. Infections were mainly meningitis (n = 71; 78%). Median duration of linezolid or vancomycin treatment was 7 days (IQR 4; 13). Treatment failure occurred in 18.6% (n = 17) of patients (infection persisted in 9.8% of patients (n = 9), infection relapsed in 6.6% (n = 6) and infection caused a fatal outcome in 4.4% (n = 4). In the Cox proportional hazards regression model, vancomycin was not associated with treatment failure (aHR 2.90; 95% CI [0.93-9.30]; p = 0.066). Using propensity score, vancomycin was associated with treatment failure (HR 3.28; 95% CI [1.02-10.54]; p = 0.045). Treatment with vancomycin was also associated with AE (HR 8.42; CI 95% [2.44;29.10]; p = 0.019).
conclusionPatients treated with vancomycin for staphylococcal-associated CNS infections seems to have a higher risk of treatment failure and AE compared to those treated with linezolid. However, given the low statistical power and the observational nature of this study, further research is needed to confirm these findings.
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