Linezolid or Vancomycin for MRSA Pneumonia

A was recently in the for influenza.
He is readmitted 2 weeks later with pneumonia.

Which EMPIRIC anti-MRSA agent is the best choice?
1. Vancomycin
2. Linezolid

How did others respond?

Reveal the answer

Best Answer

Vancomycin

Explanation: Using empiric vancomycin can help preserve linezolid activity against vancomycin-resistant Enterococcus.
Positioning vancomycin as an empiric option and linezolid as a definitive therapy may be a strategy to control linezolid overuse and prevent resistance 🎉

New vancomycin resistance is rare BUT new linezolid resistance can occur easily! One institution had a 400% ⬆️ in linezolid resistant VRE when linezolid use increased 350% 🤯 Treatment options for VRE are limited so preserving activity when we can is important!

Empiric vancomycin for MRSA coverage may help prevent the development of linezolid resistant isolates BUT keep in mind linezolid is one of our oral options for MRSA pneumonia 💊