Research Notes — Linezolid best for hospital-acquired pneumonia? Maybe not

A study by a UNMC 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.

Andre Kalil, M.D.

The study, published 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.

Another take

Despite these downsides, 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.

“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,” he said.

Other options

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).