PMID- 25982913
OWN - NLM
STAT- MEDLINE
DCOM- 20160229
LR  - 20150610
IS  - 1872-7913 (Electronic)
IS  - 0924-8579 (Linking)
VI  - 46
IP  - 1
DP  - 2015 Jul
TI  - Review of meta-analyses of vancomycin compared with new treatments for 
      Gram-positive skin and soft-tissue infections: Are we any clearer?
PG  - 1-7
LID - S0924-8579(15)00156-9 [pii]
LID - 10.1016/j.ijantimicag.2015.03.011 [doi]
AB  - Vancomycin has been considered the standard of care for treatment of 
      Gram-positive skin and soft-tissue infections (SSTIs). Its value has been 
      questioned over the last decade owing to well acknowledged limitations in 
      efficacy and tolerability and the emergence of newer meticillin-resistant 
      Staphylococcus aureus (MRSA)-active antibacterial agents. However, no single 
      agent has shown better results versus vancomycin in SSTI trials. The aim of this 
      review was to identify and summarise data from meta-analyses (MAs) for the 
      treatment of Gram-positive and MRSA SSTIs. A systematic search identified 21 
      published MAs examining the use of newer antibiotics and vancomycin in SSTIs. In 
      terms of clinical and microbiological efficacy, linezolid (in Gram-positive and 
      MRSA SSTIs) and telavancin (in MRSA SSTIs) were shown to be more effective than 
      vancomycin. The safety of newer antimicrobials in general was comparable with 
      vancomycin, except for telavancin, which was associated with more severe adverse 
      events (AEs), and tigecycline owing to an all-cause mortality imbalance observed 
      in all infections but not confirmed in SSTIs. Specific AEs were related to the 
      use of newer agents, such as nephrotoxicity for telavancin, creatine 
      phosphokinase elevations for daptomycin, and thrombocytopenia with linezolid. 
      Some evidence suggests that daptomycin could be associated with reduced treatment 
      duration, and linezolid with reduced length of intravenous treatment and hospital 
      length of stay compared with vancomycin. Considering the limitations of this type 
      of research and the comparative efficacy results demonstrated in head-to-head 
      randomised controlled trials, data are still not sufficient to support the 
      widespread use of new agents over vancomycin.
CI  - Copyright (c) 2015 Elsevier B.V. and the International Society of Chemotherapy. All 
      rights reserved.
FAU - Tsoulas, Christos
AU  - Tsoulas C
AD  - Institute of Continuing Medical Education of Ioannina, Harilaou Trikoupi 10, 
      45333 Ioannina, Greece. Electronic address: christsoulas@gmail.com.
FAU - Nathwani, Dilip
AU  - Nathwani D
AD  - Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20150430
PL  - Netherlands
TA  - Int J Antimicrob Agents
JT  - International journal of antimicrobial agents
JID - 9111860
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Anti-Bacterial Agents/adverse effects/pharmacology/*therapeutic use
MH  - Drug-Related Side Effects and Adverse Reactions/epidemiology
MH  - Gram-Positive Bacteria/*drug effects
MH  - Gram-Positive Bacterial Infections/*drug therapy/microbiology
MH  - Humans
MH  - Skin Diseases, Bacterial/*drug therapy/microbiology
MH  - Soft Tissue Infections/*drug therapy/microbiology
MH  - Treatment Outcome
MH  - Vancomycin/adverse effects/pharmacology/*therapeutic use
OTO - NOTNLM
OT  - Daptomycin
OT  - Linezolid
OT  - Meta-analysis
OT  - Meticillin-resistant Staphylococcus aureus (MRSA)
OT  - Skin and soft-tissue infection
OT  - Vancomycin
EDAT- 2015/05/20 06:00
MHDA- 2016/03/02 06:00
CRDT- 2015/05/19 06:00
PHST- 2014/12/11 00:00 [received]
PHST- 2015/03/16 00:00 [revised]
PHST- 2015/03/18 00:00 [accepted]
PHST- 2015/05/19 06:00 [entrez]
PHST- 2015/05/20 06:00 [pubmed]
PHST- 2016/03/02 06:00 [medline]
AID - S0924-8579(15)00156-9 [pii]
AID - 10.1016/j.ijantimicag.2015.03.011 [doi]
PST - ppublish
SO  - Int J Antimicrob Agents. 2015 Jul;46(1):1-7. doi: 
      10.1016/j.ijantimicag.2015.03.011. Epub 2015 Apr 30.