Efficacy and Safety of Contezolid as Salvage Treatment for Gram-Positive Bacterial Infections: A Retrospective Multicenter Study

Shujuan Ji,1 Zhihui Zhou,1 Yan Chen,1 Lu Sun,1 Binfeng Yu,1 Yunsong Yu2 1Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of ChinaCorrespondence: Yunsong Yu, Email [email protected]: The primary objective of this study was to evaluate the efficacy and safety of contezolid from vancomycin or linezolid in cases of Gram-positive bacterial infections with insufficient clinical efficacy or adverse reactions.Methods: This was a retrospective, multicenter study. Patients were eligible for inclusion if they were treated with vancomycin or linezolid for a diagnosis of Gram-positive bacterial infection and were switched to least 3 doses of contezolid due to poor efficacy or adverse effects. Relevant clinical details were collected by medical record review.Results: A total of 191 patients from 34 hospitals in China were included. Based on clinical efficacy and microbiological clearance rate, the overall response rate of contezolid is 96.86%. Among patients switched to contezolid due to adverse reactions with linezolid or vancomycin, clinical improvement was observed in 121/131 (92.37%). Eight new adverse events occurred, six of which were related to contezolid (3.14%).Conclusion: In this observational study, switching from vancomycin or linezolid to contezolid in cases of inadequate clinical efficacy or adverse reactions was associated with favorable clinical outcomes and demonstrated promising effectiveness in a real-world setting. Causality cannot be inferred from these data. Contezolid may represent a therapeutic option for patients intolerant to or failing initial therapy, though prospective controlled studies are needed to confirm these findings.Keywords: contezolid, linezolid, vancomycin, gram-positive bacterial infections