A study by a University of Nebraska Medical Center infectious disease specialist has determined that one of the most popular antibiotics used to treat hospital-acquired (nosocomial) pneumonia may not be the best choice.
The study, published recently in Critical Care Medicine Journal, found that Linezolid caused a significant increase in side effects such as nausea, vomiting and diarrhea and also led to significant more thrombocytopenia, a dangerous condition in which platelets are too low.
Despite these effects, the drug is often regarded as superior in combating the illness although no clinical trials has verified this widely held belief. Until now.
For Andre Kalil, M.D., an infectious disease specialist and UNMC associate professor of internal medicine, reputation of superiority wasn’t enough. He and a team of infectious disease researchers, including Mark Rupp, M.D., recently studied nine randomized trials on 2,329 patients with nosocomial pneumonia to test Linezolid’s effectiveness against vancomycin or teicloplanin.
“After a comprehensive methodological approach, we found that Linezolid was not superior in terms of curing nosocomial pneumonia, but it also was associated with significant increase in side effects such as nausea, vomiting and diarrhea, as well as thrombocytopenia (low platelets),” Dr. Kalil said. “Physicians taking care of patients with nosocomial pneumonia have support from our study to not assume that Linezolid is the only drug of choice for these patients.”
Dr. Kalil said other drugs, such as Vancomycin or Teicoplanin, are still very effective in treating nosocomial pneumonia while causing less side effects. Additionally, the overuse of Linezolid can create Linezolid-resistant nosocomial pneumonia, an already growing problem in many medical facilities. The mortality rate of Linezolid-resistant infections is 25 to 50 percent according to the Centers for Disease Control and Prevention), a can be quite problematic.
Dr. Kalil said the study can provide insight to other areas of medicine such as infectious diseases, pulmonary, medical, internal medicine and surgical critical care. The study received a special journal editorial and was among the top five best and most accessed articles in October around the world.
Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.