Linezolid for the treatment of infections caused by Gram-positive pathogens in China.

In this randomised, double-blind, comparator-controlled, multicentre study conducted in China, 142 hospitalised patients aged 18-75 years with pneumonia (n=80) or complicated skin and soft-tissue infection (cSSTI) (n=62) due to suspected or known Gram-positive pathogens were randomised (1:1) to receive either linezolid 600mg (n=71) or vancomycin 1g in patients aged < or =60 years or 0.75g in patients aged >60 years (n=71) intravenously every 12h. The duration of treatment was 10-21 days for patients with pneumonia and 7-21 days for patients with cSSTI. Clinical outcomes were assessed at end-of-treatment (EOT) visit and follow-up (FU) visit 7-28 days post therapy. Staphylococcus aureus was the most common pathogen at baseline and most of these isolates were resistant to meticillin. All isolates were susceptible to linezolid and vancomycin. For the evaluable patients, the effective treatment rate for linezolid was higher than that for vancomycin at EOT (86.9% (53/61) vs. 61.7% (37/60)) and at FU (83.1% (49/59) vs. 64.9% (37/57)). Pathogen eradication rates for the microbiologically evaluable patients at FU were 79.2% (42/53) for linezolid and 61.5% (32/52) for vancomycin. The incidence of drug-related adverse events (AEs) was 25.4% (18/71) for linezolid and 16.9% (12/71) for vancomycin. Four (5.6%) linezolid-treated and eight (11.3%) vancomycin-treated patients discontinued the study drug because of an AE. Linezolid was well tolerated and effective for the treatment of infections caused by Gram-positive pathogens, including meticillin-resistant S. aureus.

[The effect of therapeutic intervention with corticosteroids on outcome and prognosis of sarcoidosis].

OBJECTIVE: To evaluate the effects of corticosteroids on the prognosis of sarcoidosis. METHOD: There were analysis and comparison on the prognosis of natural course and corticosteroids therapy of 133 patients with sarcoidosis diagnosed by biopsy pathologic histology follow-up over 4 years. RESULTS: Six of the 7 patients with ocular sarcoidosis were cured by oral prednisone (PRED), and 1 patient receiving intraocular dexamethasone lost his sight. In patients with extra-pulmonary sarcoidosis who were not treated, 33 of the 38 cases underwent spontaneous remission, but another 5 cases progressed. Twenty-two of the 26 patients with stage I pulmonary disease underwent spontaneous remission, 3 progressed, with only one case cured by PRED therapy. In the 55 patients with stage II pulmonary sarcoidosis who received PRED therapy, the chest roentgenogram and lung function were back to normal in 45 cases, but 10 cases failed. One patient with stage II pulmonary disease without treatment progressed to stage IV. Three patients with stage III pulmonary sarcoidosis were cured by PRED therapy, but III patients with stage IV sarcoidosis failed to respond to PRED therapy. CONCLUSIONS: Systematic therapy with oral corticosteroids for ocular and stage II approximately III pulmonary sarcoidosis is a curative intervention. Corticosteroids can relieve symptoms, reduce inflammation, and improve the prognosis of ocular and pulmonary sarcoidosis.