Effects of linezolid versus vancomycin on procalcitonin and C-reactive protein in treatment of sepsis

Objective This study aimed to compare the effects of linezolid and vancomycin on procalcitonin (PCT) and C-reactive protein (CRP) in treatment of sepsis. Methods The laboratory and clinical data of sepsis patients treated with linezolid or vancomycin from January 2013 to June 2018 were retrospectively analyzed. The propensity score matching method was used to correct the confounding factors between groups. Repeated measures analysis of variance was used to compare the changes of PCT and CRP levels 3 days after linezolid or vancomycin treatment with the baseline levels before treatment (day 0). Results A total of 474 sepsis patients (249 treated with linezolid and 225 treated with vancomycin) were enrolled. After adjustment for confounding factors by matching the propensity score, the analysis showed that the PCT (5.8 vs. 3.1 μg/L, P＜0.001) and CRP (75.1 vs. 46.8 mg/L, P=0.027) levels in linezolid group significantly decreased 3 days after treatment compared with the levels on day 0 of treatment. The decrease of PCT and CRP levels in vancomycin group was not statistically significant (P＞0.05). In addition, in the 179 pairs of patients whose propensity score was matched and adjusted for confounding factors, the survival rate (86.0% vs 81.6%, P=0.251) and treatment efficacy (46.9% vs 45.3%, P=0.750) did not show significant difference between linezolid and vancomycin treatment groups. Conclusions Linezolid can significantly decrease serum levels of PCT and CRP in sepsis patients 3 days after treatment. Linezolid works more quickly but does not show significantly different treatment efficacy from vancomycin.