Effect of Vancomycin Versus Linezolid on Hospital Length of Stay in Patients With Suspected or Confirmed Influenza and Bacterial Pneumonia

Introduction Patients with influenza who then present with bacterial pneumonia often present with methicillin-resistant Staphylococcus aureus pneumonia. There is a paucity of literature about how antibiotic choice affects length of stay in these patients. The objective of this study was to assess if vancomycin or linezolid affects hospital length of stay in patients with bacterial pneumonia complicating influenza. Methods This was a single-center, retrospective cohort study conducted at the University of Tennessee Medical Center in Knoxville, Tenn. Inclusion criteria were adults 18 years or older who were admitted to the hospital with suspected postinfluenza pneumonia. In addition, these patients either received 24 hours of oseltamivir or had a positive influenza screen and received at least 24 hours of vancomycin or linezolid for empiric coverage of methicillin-resistant S. aureus pneumonia. Results A total of 186 patients were included in the study. There was no difference in overall length of stay between the linezolid and vancomycin groups (P = 0.937). Secondary outcomes included intensive care unit (ICU) length of stay and in-hospital mortality. The group treated with vancomycin had increased in-hospital mortality (P = 0.043) and longer ICU length of stay (P = 0.048). Discussion Although there was no difference in hospital length of stay between the 2 treatment groups, the vancomycin group had a longer ICU length of stay and increased mortality when compared with the linezolid group. Correspondence to: Leslie A. Hamilton, PharmD, FCCP, FCCM, BCPS, BCCCP, College of Pharmacy, University of Tennessee Health Science Center, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920. E-mail: lhamilt4@uthsc.edu. The authors have no funding or conflicts of interest to disclose. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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