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

Objective: 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