Randomised controlled trials, prospective studies, retrospective studies, case series and case reports that assessed the effectiveness and safety of linezolid for the treatment of patients with CNS infections were eligible for inclusion in the review. Outcomes of interest were cure of infection, survival and the development of adverse effects.
Most of the patients included in the studies were male and adults (median age 50 years), although the studies also included a few paediatric patients. In some of the included studies patients had undergone neurosurgical operations and/or had prosthetic devices. The most common CNS infection in the included studies was meningitis; other infections included brain abscesses, ventriculitis and ventriculo-peritoneal shunt infection. The most commonly isolated infective pathogens were penicillin-nonsusceptible Streptococcus pneumoniae, vancomycin-resistant enterococci, Nocardia spp., methicillin-resistant Staphylococcus epidermidis and methicillin-resistant Staphylococcus aureus. In most cases linezolid was used when previously administered treatment had failed or caused severe adverse effects. In other cases linezolid was administered after the detection of penicillin-nonsusceptible Streptococcus pneumoniae, or other resistant pathogens, in cerebrospinal fluid. The dosage of linezolid in adults was 600mg twice daily and the mean duration of treatment was 53 days. In the majority of studies linezolid was used in combination with another antibiotic (see paper for further details).
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.