Linezolid for the treatment of MRSA infections in children

Infections caused by methicillin-resistant strains of S. aureus (MRSA) are currently fairly widespread. Linezolid is an effective and well-tolerated antibiotic for the treatment of MRSA infections in adults, but data on the use of the drug in children have so far been insufficient.

The aim of the study, led by scientists from the United States, was to assess the clinical efficacy and safety of intravenous and oral use of linezolid in children with infectious diseases of different localization caused by MRSA.

Data were obtained in two clinical trials. The first study was conducted in outpatients aged 5 to 17 years with uncomplicated skin and soft tissue infections. 15 patients received oral linezolid treatment and 10 patients received oral cefadroxil.

In a second study, children aged 0 to 11 were hospitalized for pneumonia, bacteremia, or complicated infections of the skin and soft tissue. In all cases, the diseases were caused by resistant Gram-positive microorganisms. 20 children received linezolid iv, and in children over 3 months of age, treatment was carried out in stages: the first linezolid was administered iv and then indoors. In 14 patients, vancomycin ivcom was prescribed.

According to the results of the first study, the clinical cure rate was 92.3% in the linezolid group and 85.7% in the cefadroxil group (p = 0.64). MRSA eradication rates were 92.3% and 85.7%, respectively. During the study, no serious adverse events were recorded and the frequency of non-serious adverse events was not significant in the two groups studied.

In the second study, the clinical cure rate was 94.1% in the linezolid group and 90% in the vancomycin group (p = 0.69). The frequency of MRSA eradication was 88.2% and 90.0%, respectively (p = 0.89). In the linezolid group, fewer adverse events were noted than in the vancomycin group (20% vs 43%, p = 0.15).

Thus, the iv and oral use of linezolid is effective and safe in the treatment of children with infectious diseases of different localization caused by MRSA.