Empirical treatment with linezolid does not increase 30-day mortality rate in Gram-negative bacteremia: a propensity score analysis.
Antimicrob Agents Chemother. 2014 Sep 8;
Authors: Ternavasio-de la Vega HG, Mateos-Díaz AM, Martinez JA, Almela M, Cobos-Trigueros N, Morata L, De-la-Calle C, Sala M, Mensa J, Marcos M, Soriano A
The role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on 30-day mortality rate in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare mortality between patients who received linezolid or glycopeptides, propensity score on baseline variables was used to balance treatment groups and both propensity score matching and propensity adjusted logistic regression were used to compare 30-day mortality between groups. Overall 30-day mortality was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid and 1058 received glycopeptides. Propensity score matching included 64 patients in each treatment group. After matching, mortality was 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid and a non-significant association between linezolid empirical treatment and mortality (OR 1.63; 95%CI 0.69-3.82; P=0.275, McNemar's test) was found. This association remained non-significant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and mortality after adjusting by propensity score quintiles or other variables potentially associated with mortality. In conclusion, propensity score analysis showed that empirical treatment with linezolid compared with glycopeptides was not associated with 30-day mortality in patients with Gram-negative bacteremia.
PMID: 25199780 [PubMed - as supplied by publisher]