Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2025
Efficacy and safety of tedizolid in the treatment of acute bacterial skin and skin-structure infections: a systematic review and meta-analysis of randomised controlled trials.
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Sevilla Patricia, Martínez Altea, Pérez-Olaso Oscar, Camarena J J
Аннотация
BACKGROUND: Acute bacterial skin and skin-structure infections (ABSSSIs) are usually caused by gram-positive pathogens, particularly Staphylococcus aureus. Tedizolid, which belongs to the oxazolidinone family, has been proposed as an effective alternative to linezolid and other standard treatments because of its improved posology and safety profile.
OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of tedizolid in comparison to other antibiotics for the treatment of ABSSSIs.
METHODS: A systematic review and meta-analysis of randomised clinical trials was conducted.
DATA SOURCES: A systematic review was performed in PubMed, Web of Science, and the Cochrane Library up to May 2025.
STUDY ELIGIBLE CRITERIA: Randomised clinical trials comparing tedizolid with other antibiotics for ABSSSIs.
PARTICIPANTS AND INTERVENTIONS: Patients diagnosed with ABSSSIs treated with tedizolid vs. standard agents.
ASSESSMENT OF RISK OF BIAS: The Cochrane risk-of-bias tool was used.
METHODS OF DATA SYNTHESIS: Dichotomous outcomes were pooled using risk ratios with 95% CIs. Heterogeneity was assessed using the I2 statistic. A random-effects model was applied where appropriate. Grade of Recommendation, Assessment, Development, and Evaluation was used to evaluate the certainty of evidence. The review was prospectively registered (PROSPERO CRD420251065845).
RESULTS: Six randomised clinical trials with a total of 2277 patients (tedizolid: n = 1063; comparators: n = 1214) were included. Tedizolid showed similar efficacy to that of comparators in terms of early clinical response (risk ratios [RR], 0.99; 95% CI, 0.95-1.03), response at the end of treatment (RR, 0.98; 95% CI, 0.94-1.01), and microbiological eradication (RR, 0.98; 95% CI, 0.94-1.03). Overall, the adverse effects were comparable between the groups (RR, 1.03; 95% CI, 0.94-1.12). However, tedizolid was associated with a low risk of thrombocytopenia (RR, 0.60; 95% CI, 0.41-0.88), neutropenia (RR, 0.35; 95% CI, 0.18-0.69), and gastrointestinal disorders (RR, 0.69; 95% CI, 0.57-0.85).
CONCLUSIONS: Tedizolid demonstrated noninferior efficacy compared with standard treatments for ABSSSIs and may offer advantages in safety, especially in haematological patients. Its once-daily dosing and shorter regimen support its use as a therapeutic alternative in selected patients.
OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of tedizolid in comparison to other antibiotics for the treatment of ABSSSIs.
METHODS: A systematic review and meta-analysis of randomised clinical trials was conducted.
DATA SOURCES: A systematic review was performed in PubMed, Web of Science, and the Cochrane Library up to May 2025.
STUDY ELIGIBLE CRITERIA: Randomised clinical trials comparing tedizolid with other antibiotics for ABSSSIs.
PARTICIPANTS AND INTERVENTIONS: Patients diagnosed with ABSSSIs treated with tedizolid vs. standard agents.
ASSESSMENT OF RISK OF BIAS: The Cochrane risk-of-bias tool was used.
METHODS OF DATA SYNTHESIS: Dichotomous outcomes were pooled using risk ratios with 95% CIs. Heterogeneity was assessed using the I2 statistic. A random-effects model was applied where appropriate. Grade of Recommendation, Assessment, Development, and Evaluation was used to evaluate the certainty of evidence. The review was prospectively registered (PROSPERO CRD420251065845).
RESULTS: Six randomised clinical trials with a total of 2277 patients (tedizolid: n = 1063; comparators: n = 1214) were included. Tedizolid showed similar efficacy to that of comparators in terms of early clinical response (risk ratios [RR], 0.99; 95% CI, 0.95-1.03), response at the end of treatment (RR, 0.98; 95% CI, 0.94-1.01), and microbiological eradication (RR, 0.98; 95% CI, 0.94-1.03). Overall, the adverse effects were comparable between the groups (RR, 1.03; 95% CI, 0.94-1.12). However, tedizolid was associated with a low risk of thrombocytopenia (RR, 0.60; 95% CI, 0.41-0.88), neutropenia (RR, 0.35; 95% CI, 0.18-0.69), and gastrointestinal disorders (RR, 0.69; 95% CI, 0.57-0.85).
CONCLUSIONS: Tedizolid demonstrated noninferior efficacy compared with standard treatments for ABSSSIs and may offer advantages in safety, especially in haematological patients. Its once-daily dosing and shorter regimen support its use as a therapeutic alternative in selected patients.