Objective To systematically review the effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia. Methods Such databases as CBM, CNKI, WanFang Data, VIP, Science Direct, PubMed, Ovid, SciFinder, The Cochrane Library (Issue 3, 2013) and EMbase were electronically searched for published articles (randomized controlled trials or non-randomized prospective trials with comparable baseline between groups) at home and abroad on the clinical effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia from January 2003 to March 2013. Using the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software in clinical cure rates, clinical effective rates, microbiologic eradication rates, and adverse reaction incidences. Results Finally, 7 studies were included involving 637 patients. The results of meta-analysis were clinical effective rates (RR=1.17, 95%CI 1.04 to 1.32, P=0.009), clinical cure rates (RR=1.06, 95%CI 0.94 to 1.19, P=0.37), bacterial clearance rates (RR=1.32, 95%CI 1.03 to 1.68, P=0.03), and adverse events rates (RR=1.24, 95%CI 0.78 to 1.97, P=0.37). The results of Begg test and Egger test were not significant (Pgt;0.05). Conclusion Current evidence shows that, in treating MRSA pneumonia, linezolid is better than teicoplanin in clinical effective rates and bacterial clearance rates. However, they are alike in clinical cure rates and bacterial clearance rates.
ObjectiveTo systematically review the therapeutic effects and safety of teicoplanin versus vancomycin for severe gram-positive bacterial infection. MethodsWe electronically searched CBM, CNKI, VIP, WanFang Data, PubMed, EMbase, The Cochrane Library (Issue 3, 2013) and Springer for the internationally-nationally published randomized controlled trials (RCTs) on teicoplanin versus vancomycin for severe gram-positive bacterial infections from inception to October 2013. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsTwenty RCTs were finally included, involving 1 555 patients with severe gram-positive bacterial infection. The results of meta-analysis showed that there was no significant difference between teicoplanin and vancomycin with regard to all-cause mortality (OR=1.67, 95%CI 0.86 to 3.23, P=0.13), clinical cure rates (OR=1.24, 95%CI 0.95 to 1.60, P=0.11), effective rates (OR=1.03, 95%CI 0.75 to 1.41, P=0.87), and bacterial clearance rates (OR=0.96, 95%CI 0.66 to 1.39, P=0.83). However, the incidence of adverse reaction was lower in the teicoplanin group than in the vancomycin with a significant difference (OR=0.50, 95%CI 0.34 to 0.72, P=0.000 2). ConclusionThe results of meta-analysis shows that, teicoplanin is similar to vancomycin in therapeutic effects on treating severe gram-positive bacterial infection but it is better in safety. However, because of limited quantity and quality of the included studies, the above conclusion needs to be further verified by conducting more high-quality studies.
ObjectiveTo systematically evaluate the efficacy and safety of teicoplanin versus vancomycin for lower respiratory tract infection with gram-positive bacteria in Chinese population. MethodsThe PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CNKI, and WanFang Data databases were searched from their inception to March 20, 2016, to collect randomized controlled trials about teicoplanin versus vancomycin for lower respiratory tract infection with gram-positive bacteria in Chinese population. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 12 RCTs involving 921 patients were included. The results of meta-analysis suggested that there were no significant associations between the teicoplanin group and the vancomycin group in total effective rate (RR=0.99, 95%CI 0.93 to 1.05, P=0.69), clinical cure rate (RR=1.05, 95%CI 0.92 to 1.19, P=0.49), and bacteria clearance rate (RR=1.00, 95%CI 0.93 to 1.05, P=0.69). However, the teicoplanin group had lower incidences of the total adverse event (RR=0.65, 95%CI 0.47 to 0.90, P=0.008) and nephrotoxicity (RR=0.33, 95%CI 0.16 to 0.66, P=0.002), and shorter course of treatment (MD=-1.78, 95%CI -3.27 to -0.29, P=0.02) than that in the vancomycin group. ConclusionCurrent evidence indicates that teicoplanin is similar to vancomycin in therapeutic effects on treating lower respiratory tract infection with gram-positive bacteria in Chinese population, but teicoplanin is better in safety and has a shorter course of treatment than vancomycin. Due to limited quantity and quality of the included studies, more high-quality RCTs are needed to confirm the above conclusions.