Tratamiento de la bacteriemia por enterococo resistente a vancomicina con daptomicina versus linezolid: revisión sistemática y metanálisis

Edgar Yaset Caicedo-Ochoa, Jorge Andrés Urrutia-Gómez, Daniel Sebastián Fernández-Niño, Santiago Alejandro Guío-Guerra, Yardany Rafael Méndez-Fandiño

Resumen


Introducción: para el tratamiento de las infecciones por Enterococcus resistente a vancomicina (ERV) se emplean fármacos de segunda línea como daptomicina y linezolid.

Objetivo: hacer una revisión sistemática para evaluar el tratamiento de la bacteriemia por ERV, con daptomicina o linezolid.

Metodología: búsqueda electrónica en las bases de datos de Pubmed, Embase, Scopus, ScienceDirect, CENTRAL, Lilacs y Google Académico, para identificar estudios anteriores a julio de 2015 que hayan comparado los tratamientos con daptomicina o linezolid de pacientes infectados por ERV.

Resultados: se incluyeron 15 estudios de 1307 registros. No hubo diferencias entre daptomicina y linezolid con respecto a la mortalidad a 30 días. Con la daptomicina se logró más tempranamente el control microbiológico (OR: 0,64; IC95 %: 0,45-0,92). No hubo diferencias entre los dos antibióticos en cuanto a la mejoría clínica, la necesidad de admisión a la UCI o la aparición de efectos adversos como trombocitopenia, neutropenia e insuficiencia renal.

Conclusiones: no encontramos diferencias entre daptomicina y linezolid en cuanto a la mortalidad de pacientes infectados por ERV, aunque con la daptomicina se logró una cura microbiológica más rápida.


Palabras clave


Daptomicina; Enterococcus; Linezolid; Mortalidad; Resistencia a Antimicrobianos

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Referencias


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DOI: https://doi.org/10.17533/udea.iatreia.v30n1a01 Resumen : 2995 PDF : 1750 XHTML : 10

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