Background and aims: Gram-positive infections in burn patients present significant treatment challenges. This study compared the efficacy and safety of linezolid vs. teicoplanin for managing such infections in a clinical setting.
Methods: We conducted a retrospective study involving 77 burn patients with confirmed Gram-positive infections at Shahid Motahari Hospital (2020-2022). Participants were allocated to: linezolid 600 mg BID (n = 40), teicoplanin 400 mg daily (n = 32), or combination therapy (n = 5). Primary endpoints were treatment duration and mortality; secondary endpoints included safety outcomes. Statistical analyses used SPSS v25 with two-tailed tests (α = 0.05).
Results: Linezolid demonstrated superior outcomes compared to teicoplanin: treatment duration was significantly shorter (5.68 ± 2.88 vs. 10.53 ± 6.86 days; mean difference -4.85 [95% CI -7.12 to -2.58], p < 0.001), mortality lower (5.0% vs. 40.6%; OR = 0.09 [0.02-0.42], p = 0.002), and time to clinical improvement faster (4.94 ± 2.21 vs. 9.88 ± 5.95 days, p < 0.001). Safety profiles were comparable (thrombocytopenia: 5.0% vs. 12.5%, p = 0.602).
Conclusion: Linezolid showed significantly better efficacy than teicoplanin for Gram-positive burn infections, with reduced treatment duration and mortality while maintaining similar safety. Teicoplanin remains an alternative for specific cases.
Keywords: S. aureus; antibiotic; burn injuries; linezolid; teicoplanin.
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