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10.1002/phar.1771 http://scihub22266oqcxt.onion/10.1002/phar.1771 C4958533!4958533 !27208687     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27208687 &cmd=llinks): Failed to open stream: HTTP request failed! 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Comparison of Linezolid and Vancomycin for Methicillin-Resistant Staphylococcus aureus Pneumonia: Institutional Implications |pdf=|usr=}}{{27208687 }} gab.com Text Comparison of Linezolid and Vancomycin for Methicillin-Resistant Staphylococcus aureus Pneumonia: Institutional Implications JO: Pharmacotherapy http://www.kidney.de/pget.php?&tw=1&pmid=27208687 #FOAvip OBJECTIVE: Recent studies suggesting clinical superiority of linezolid over vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia led to a change in our institution's clinical pathway/order form for hospital-acquired pneumonia, positioning linezolid as the preferred agent. Our objective was to assess the impact of this change within our institution. DESIGN: Retrospective electronic medical records review. METHODS: The analysis for this observational study included eligible patients admitted to our medical center between May 1, 2011, and August 31, 2014, with ICD-9 codes for MRSA and pneumonia. Included patients were at least 18 years of age and had vancomycin or linezolid initiated at least 2 days after admission and continued for at least 2 consecutive days. The primary end points were extent of antibiotic use before and after order form change and length of stay (LOS) and hospital charges in the two treatment groups. A secondary aim was to detect any gross discrepancies in patient outcomes such as treatment duration, mechanical ventilation duration, all-cause mortality rate, nephrotoxicity, and 30-day readmission between the two treatment groups. MEASUREMENTS AND MAIN RESULTS: Outcomes in 227 patients were assessed. Linezolid use increased 16.2% subsequent to the change in the order form. Although not statistically significant, the median hospital admission charge was $6200 lower in patients treated with linezolid compared with those treated with vancomycin ($25,900 vs $32,100). Hospital LOS was significantly associated with Charlson Comorbidity Index score (p<0.001), type of treatment (p=0.032), duration of treatment (p<0.001), mechanical ventilation (p<0.001), and intensive care unit admission (p<0.001). All-cause mortality favored linezolid treatment, and these patients were more likely to be discharged (shorter LOS). CONCLUSIONS: Although linezolid use increased markedly with this pathway/order form change, no negative institutional consequences or unfavorable patient outcomes were detected, justifying the change in policy from these perspectives. Twit Text FOAVip Comparison of Linezolid and Vancomycin for Methicillin-Resistant Staphylococcus aureus Pneumonia: Institutional Implications ????Pharmacotherapy http://www.kidney.de/pget.php?&tw=1&pmid=27208687 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27208687 #FOAvip English Wikipedia <ref>{{Cite pmid|27208687 }}</ref> Comparison of Linezolid and Vancomycin for Methicillin-Resistant Staphylococcus aureus Pneumonia: Institutional Implications #MMPMID27208687 Tong MC ; Wisniewski CS ; Wolf B ; Bosso JA Pharmacotherapy 2016[Jul]; 36 (7 ): 731-9 PMID27208687 show ga OBJECTIVE: Recent studies suggesting clinical superiority of linezolid over vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia led to a change in our institution's clinical pathway/order form for hospital-acquired pneumonia, positioning linezolid as the preferred agent. Our objective was to assess the impact of this change within our institution. DESIGN: Retrospective electronic medical records review. METHODS: The analysis for this observational study included eligible patients admitted to our medical center between May 1, 2011, and August 31, 2014, with ICD-9 codes for MRSA and pneumonia. Included patients were at least 18 years of age and had vancomycin or linezolid initiated at least 2 days after admission and continued for at least 2 consecutive days. The primary end points were extent of antibiotic use before and after order form change and length of stay (LOS) and hospital charges in the two treatment groups. A secondary aim was to detect any gross discrepancies in patient outcomes such as treatment duration, mechanical ventilation duration, all-cause mortality rate, nephrotoxicity, and 30-day readmission between the two treatment groups. MEASUREMENTS AND MAIN RESULTS: Outcomes in 227 patients were assessed. Linezolid use increased 16.2% subsequent to the change in the order form. Although not statistically significant, the median hospital admission charge was $6200 lower in patients treated with linezolid compared with those treated with vancomycin ($25,900 vs $32,100). Hospital LOS was significantly associated with Charlson Comorbidity Index score (p<0.001), type of treatment (p=0.032), duration of treatment (p<0.001), mechanical ventilation (p<0.001), and intensive care unit admission (p<0.001). All-cause mortality favored linezolid treatment, and these patients were more likely to be discharged (shorter LOS). CONCLUSIONS: Although linezolid use increased markedly with this pathway/order form change, no negative institutional consequences or unfavorable patient outcomes were detected, justifying the change in policy from these perspectives. |Adolescent [MESH] |Adult [MESH] |Aged [MESH] |Aged, 80 and over [MESH] |Anti-Bacterial Agents/*therapeutic use [MESH] |Female [MESH] |Health Care Costs [MESH] |Hospitalization/economics [MESH] |Humans [MESH] |Length of Stay [MESH] |Linezolid/*therapeutic use [MESH] |Male [MESH] |Methicillin-Resistant Staphylococcus aureus/*drug effects [MESH] |Middle Aged [MESH] |Pneumonia, Staphylococcal/*drug therapy [MESH] |Retrospective Studies [MESH]Comparison of Linezolid and Vancomycin for Methicillin-Resistant Staph(epmc).pdf DeepDyve Pubget Overpricing