Linezolid Alone or Combined With Carbapenem Against Methicillin-resistant Staphylococcus Aureus (MRSA) in Ventilator-associated Pneumonia
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Purpose
As previous studies showed that the synergy between linezolid and carbapenem in vitro and in vivo (animal studies), our study is aim to investigate the activity of linezolid, alone and in combination with carbapenem against methicillin-resistant Staphylococcus aureus (MRSA) in ventilator-associated pneumonia (VAP) patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Methicillin-resistant Staphylococcus Aureus Pneumonia, Ventilator-Associated |
Drug: Imipenem/cilastatin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Linezolid Alone or Combined With Carbapenem Against Methicillin-resistant Staphylococcus Aureus (MRSA) in Vitro and in Ventilator-associated Pneumonia |
- MRSA eradication [ Time Frame: 7 th day ] [ Designated as safety issue: No ]The investigators study the efficacy of Linezolid combined with Imipenem to treat the MRSA VAP, the investigators proposed the 7th day's MRSA eradication would be better than Linezolid alone.
- MRSA eradication [ Time Frame: 14th day ] [ Designated as safety issue: No ]
- mortality [ Time Frame: 28th day ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | June 2011 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: Linezolid alone
the control group is designed for linezolid alone treated MRSA VAP (standard treatment).
|
Drug: Imipenem/cilastatin
the intervention group was designed for combined linezolid plus imipenem for treating MRSA VAP
|
Detailed Description:
Linezolid is the only commercially available oxazolidinone, the first new class of antibiotic to be developed in the last three decades. Although it is predominantly bacteriostatic, linezolid has good in vitro and in vivo activity against MRSA . However, several studies did not show that linezolid was superior to any of glycopeptides in treatment of MRSA pneumonia. Moreover, combination therapy against MRSA is argued when several in vitro and in vivo studies showed synergy between linezolid and carbapenem or fosfomycin or rifampicin, while vancomycin and linezolid in combination should be avoided. our study is aim to investigate the activity of linezolid, alone and in combination with carbapenem against methicillin-resistant Staphylococcus aureus (MRSA) in ventilator-associated pneumonia (VAP) patients.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Pneumonia, Ventilator-associated
- the presence of new or persistent radiographic features
- fever higher than 38°C
- leukocytosis (≥11.0 ×109/L) or neutropenia (≤3.5×109/L)
- purulent endotracheal
- increasing oxygen requirements
- Endotracheal aspiration culture show methicillin-resistant S. aureus positive
Exclusion Criteria:
- immunocompromised patients (postorgan transplantation or human immunodeficiency virus-infected or neutropenic [≤1×109/L absolute neutrophils], or patients receiving corticosteroids >20 mg/d for 6 months)
- colonized chronically with methicillin-resistant S. aureus
- pregnancy
- endotracheal aspiration culture showed no MRSA
Contacts and Locations| Contact: Zhi-Tao Yang, M.D. | 008613611965436 | yangzhitao@hotmail.fr |
| Study Director: | Er-Zhen Chen, M.D. & Ph.D. | Emergency intensive care unit, Ruijin Hospital |
| Principal Investigator: | Hong-Ping Qu, M.D. | Respiratory intensive care unit, Ruijin Hospital |
| Principal Investigator: | Yu-Xing Ni, M.D. & Ph.D. | Microbiology laboratory, Ruijin Hospital |
| Study Chair: | Zhi-Tao Yang, M.D. | Emergency Department, Ruijin Hospital |
More Information
Publications:
| Responsible Party: | YANG Zhi-Tao, Emergency Department, Ruijin Hospital |
| ClinicalTrials.gov Identifier: | NCT01356472 History of Changes |
| Other Study ID Numbers: | MRSA-VAP YANG ZT CN |
| Study First Received: | May 17, 2011 |
| Last Updated: | May 18, 2011 |
| Health Authority: | China: Ethics Committee China: Ministry of Health |
Keywords provided by Ruijin Hospital:
|
Methicillin-resistant Staphylococcus aureus Pneumonia, Ventilator-Associated linezolid imipenem/cilastatin |
Additional relevant MeSH terms:
|
Pneumonia Staphylococcal Infections Pneumonia, Ventilator-Associated Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections Gram-Positive Bacterial Infections Bacterial Infections Cross Infection Infection Ventilator-Induced Lung Injury Lung Injury |
Cilastatin Linezolid Imipenem Methicillin Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Protein Synthesis Inhibitors |
ClinicalTrials.gov processed this record on June 13, 2013