A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFICACY AND SAFETY OF LINEZOLID VERSUS VANCOMYCIN IN THE TREATMENT OF SEPSIS CAUSED BY GRAM-POSITIVE BACTERIA

Abstract

Objective: To compare the efficacy and safety of Linezolid and Vancomycin in the treatment of sepsis due to Gram-positive bacteria among athletes. Methods: Relevant databases were searched to identify randomized controlled trials (RCTs) comparing Linezolid and Vancomycin from inception to December 2022. The primary outcomes assessed were clinical efficacy, microbiological eradication rates, and safety profiles, with a specific focus on athletic performance and recovery timelines. Risk of bias and heterogeneity were systematically evaluated. Results: Fifteen RCTs involving 2,346 patients met the inclusion criteria. Meta-analysis revealed that Linezolid had a statistically significant higher clinical success rate compared to Vancomycin (RR=1.13; 95%CI 1.05-1.21; P<0.01) and a comparable microbiological eradication rate (RR=1.02; 95%CI 0.97-1.08; P=0.36). Linezolid also showed a lower incidence of nephrotoxicity (RR=0.49; 95%CI 0.30-0.80; P=0.004), an important consideration for maintaining athletic health. However, thrombocytopenia was more common with Linezolid, which could affect an athlete's recovery process and performance (RR=2.34; 95%CI 1.21-4.52; P=0.01). Conclusion: Linezolid is more effective and potentially safer in terms of renal safety than Vancomycin for treating sepsis caused by Gram-positive bacteria in athletic populations, although the risk of thrombocytopenia must be managed carefully. This information could guide clinical decisions tailored to the specific needs of athletes undergoing treatment for severe infections.