Archive for March 21, 2018

Treatment of hospital-acquired pneumonia with linezolid or vancomycin: a systematic review and meta-analysis.

BMJ Open. 2013 Oct 14;3(10):e003912.

Kalil AC1, Klompas M, Haynatzki G, Rupp ME.

Author information

1 Infectious Diseases Division, Internal Medicine Department, University of Nebraska Medical Center, Omaha, Nebraska, USA.

Abstract

OBJECTIVE:

Hospital-acquired pneumonia remains the most lethal and expensive nosocomial infection worldwide. Optimal therapy remains controversial. We aimed to compare mortality and clinical response outcomes in patients treated with either linezolid or vancomycin.

DESIGN:

Systematic review and meta-analysis.

DATA SOURCES:

PubMed, EMBASE, Cochrane Library, American College of Physicians Journal Club, Evidence-based Medicine BMJ and abstracts from infectious diseases and critical care meetings were searched through April 2013.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES:

All randomised clinical trials comparing linezolid to vancomycin for hospital-acquired pneumonia.

DATA EXTRACTION:

Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. One author extracted the data and two authors rechecked and verified all data.

RESULTS:

Nine randomised trials with a total of 4026 patients were included. The adjusted absolute mortality risk difference (RD) between linezolid and vancomycin was 0.01% (95% CI -2.1% to 2.1%; p=0.992; I(2)=13.5%. The adjusted absolute clinical response difference was 0.9% (95% CI -1.2% to 3.1%; p=0.409; I(2)=0%. The risk of both microbiological (RD=5.6%, 95% CI -2.2% to 13.3%; p=0.159; I(2)=0%) and methicillin-resistant Staphylococcus aureus (RD=6.4%, 95% CI -4.1% to 16.9%; p=0.230; I(2)=0%) eradication were not different between linezolid and vancomycin. Gastrointestinal side effects were more frequent with linezolid (RD=0.8% (95% CI 0% to 1.5%; p=0.05), but no differences were found with renal failure, thrombocytopenia and drug discontinuation due to adverse events. Our sample size provided 99.9% statistical power to detect differences between drugs regarding clinical response and mortality.

CONCLUSIONS:

Linezolid and vancomycin have similar efficacy and safety profiles. The high statistical power and the near-zero efficacy difference between both antibiotics demonstrates that no drug is superior for the treatment of hospital-acquired pneumonia.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808765/pdf/bmjopen-2013-003912.pdf

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March 21, 2018 at 9:28 am

Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights

Proceedings of the National Academy of Sciences March 2018

Vicki Stover Hertzberg, Howard Weiss, Lisa Elon, Wenpei Si, Sharon L. Norris and The FlyHealthy Research Team

With over 3 billion airline passengers annually, the inflight transmission of infectious diseases is an important global health concern.

Over a dozen cases of inflight transmission of serious infections have been documented, and air travel can serve as a conduit for the rapid spread of newly emerging infections and pandemics.

Despite sensational media stories, risks of transmission of respiratory viruses in an airplane cabin are unknown.

Movements of passengers and crew may facilitate disease transmission.

On 10 transcontinental US flights, we chronicled behaviors and movements of individuals in the economy cabin on single-aisle aircraft. We simulated transmission during flight based on these data.

This data-driven, dynamic network transmission model of droplet-mediated respiratory disease is unique.

FULL TEXT

http://www.pnas.org/content/early/2018/03/13/1711611115

PDF

http://www.pnas.org/content/pnas/early/2018/03/13/1711611115.full.pdf

March 21, 2018 at 9:26 am


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