Journal Article

Prospective, randomized study comparing quinupristin–dalfopristin with linezolid in the treatment of vancomycin-resistant <i>Enterococcus faecium</i> infections

Issam Raad, Ray Hachem, Hend Hanna, Claude Afif, Carmen Escalante, Hagop Kantarjian and Kenneth Rolston

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 4, pages 646-649
Published in print April 2004 | ISSN: 0305-7453
Published online April 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh144
Prospective, randomized study comparing quinupristin–dalfopristin with linezolid in the treatment of vancomycin-resistant Enterococcus faecium infections

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Objectives: Quinupristin–dalfopristin and linezolid have been shown to be efficacious in the treatment of vancomycin-resistant Enterococcus faecium (VREF) infections. However, the two antibiotics have not been compared in terms of safety and efficacy in a prospective randomized study. The objective of this study was to compare the safety and efficacy of the two drugs in the treatment of VREF infections in cancer patients.

Patients and methods: Forty cancer patients with VREF infection were randomized to receive linezolid 600 mg every 12 h or quinupristin–dalfopristin 7.5 mg/kg every 8 h. All patients were followed up for 30 days after discontinuation of study drugs.

Results: Linezolid and quinupristin–dalfopristin had comparable clinical responses (58% and 43%, respectively, P = 0.6). Myalgias and/or arthralgias occurred at a frequency of 33% in patients who received quinupristin–dalfopristin, but were not observed in the linezolid group (P = 0.03). In contrast, drug-related thrombocytopenia occurred in 11% of patients who received linezolid, but was not observed in the quinupristin–dalfopristin group (P = 0.2).

Conclusion: In cancer patients, quinupristin–dalfopristin treatment is associated with a relatively high frequency of myalgias/arthralgias; however, profound thrombocytopenia might limit the choice of linezolid in a subpopulation of cancer patients.

Keywords: Keywords: enterococcal infections, enterococcal bacteraemia, resistant Gram-positive infections, Synercid, Zyvox

Journal Article.  2454 words. 

Subjects: Medical Oncology ; Critical Care

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