To compare the efficacy and safety of linezolid and vancomycin in patients diagnosed as gram positive bacterial infections after receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).

A total of 131 patients who were confirmed or suspected as gram positive coccal infections after allo-HSCT were enrolled in our study from July 2010 to December 2012. Patients were administrated with linezolid (600 mg every 12 h) or vancomycin (1 g every 12 h). Clinical efficacy and safety were compared between the two groups.

A total of 136 cases were detected gram positive coccal infections, among whom 120 cases were evaluable. Finally, 37 cases receiving linezolid and 83 cases receiving vancomycin were enrolled in this study. Clinical cure rates of infections were 81.1%(30/37) and 88.0%(73/83) in linezolid and vancomycin groups, respectively(P=0.319). The incidence of adverse reactions was similar in the two groups[50.0%(23/40) vs 45.6%(41/90), P=0.623]. Drug-related renal function injury was mild [6.5%(3/46) vs 6.7%(6/90), P=1.000]. The occurrence of liver damage with moderate and severe elevation enzymes was also similar between the two groups [2.2%(1/46) vs 6.7%(6/90), P=0.244]. As for hematologic events, linezolid was not found to have a negative effect on hematopoietic reconstitution.

Linezolid is as effective as vancomycin in the treatment of gram positive bacterial infections after allo-HSCT. Safety of Linezolid is also comparable with that of vancomycin, which needs to be further studied due to the complex interaction of medication in this special population.

Allogeneic hematopoietic stem cell transplantation; Vancomycin; Linezolid