Evaluation of Patients With Methicillin-Resistant Staphylococcus Aureus Hospital-Acquired Pneumonia Treated With Linezolid or Vancomycin

• Clinical outcomes: Cured defined as the complete resolution of signs and symptoms of pneumonia; improvement defined as a partial resolution of signs and symptoms of pneumonia; failure defined as the deterioration of signs and symptoms of pneumonia. [ Time Frame: Up to 28 days after the diagnosis of hospital-acquired pneumonia (HAP) ] [ Designated as safety issue: No ]
• Microbiological outcomes will be defined as: superinfections and colonization (positive cultures with a multi-drug resistant organism). [ Time Frame: Up to 28 days after the diagnosis of HAP ] [ Designated as safety issue: No ]
• Economic Outcomes: Calculations regarding cost of care for each study arm. [ Time Frame: Up to 28 days after the diagnosis of HAP ] [ Designated as safety issue: No ]

The objective of this study is to review the local management of patients with methicillin-resistant Staphylococcus aureus hospital-acquired pneumonia treated with vancomycin or linezolid with the goal to define if any difference exists among these antimicrobials in regard to clinical and economic outcomes.

Non-randomized, retrospective, observational study

This non-interventional study will retrospectively evaluate patients with documented MRSA hospital-acquired including ventilator-associated pneumonia treated with linezolid or vancomycin with incorporation of 100 patients in the vancomycin arm and 100 patients in the linezolid arm.

• Methicillin-Resistant Staphylococcus Aureus (MRSA)
• Hospital-Acquired Pneumonia

• Drug: Linezolid
  Patients with documented MRSA hospital-acquired or ventilator-associated pneumonia treated with linezolid according to routine medical care.
  Other Name: Zyvox
• Drug: Vancomycin
  Patients with documented MRSA hospital-acquired or ventilator-associated pneumonia treated with vancomycin according to routine medical care.
  Other Name: Vancocin

• Linezolid observational cohort
  Intervention: Drug: Linezolid
• Vancomycin observational cohort
  Intervention: Drug: Vancomycin

Inclusion Criteria:

Patients will be enrolled in the study if they fulfill the following three inclusion criteria:

1. Protocol criteria for HAP/VAP: Criteria for making a correct diagnosis of HAP will be met if the patient develops a new or progressive pulmonary infiltrate associated with at least two of the following: new or increased respiratory symptomatology (cough, sputum or tracheal secretions, shortness of breath), fever or hypothermia, leukocytosis, left shift, or leukopenia, or deterioration of pulmonary function.
2. Isolation of MRSA from a respiratory sample or blood culture within 48 hours of the diagnosis of HAP/VAP
3. Treatment of MRSA HAP/VAP with either vancomycin or linezolid with incorporation of 100 patients in the vancomycin arm and 100 patients in the linezolid arm

Exclusion Criteria:

Patients not meeting enrollment criteria.

• University of Louisville
• Henry Ford Hospital
• Summa Health System
• Sparrow Health System
• Jackson Memorial Hospital