SynthesisInfection2026
Efficacy and safety of vancomycin versus 13 alternatives in MRSA-confirmed skin and soft tissue infections: a meta-analysis of 39 randomized controlled trials.
Synthesis in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
purposeVancomycin is the standard therapy for suspected or confirmed Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI). Although newer anti-MRSA agents claim improved efficacy and safety, evidence in microbiologically confirmed MRSA-SSTI remains limited and heterogenous. Thus, this study aimed to systematically compare the efficacy and safety of alternative agents versus vancomycin in adults with confirmed MRSA-SSTI.
methodsThree databases were searched until August 05, 2025, to retrieve randomized controlled trials (RCTs) from published meta-analyses evaluating vancomycin versus alternatives involving patients with MRSA-confirmed SSTI. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using random-effects model. The study is registered in PROSPERO (CRD420251119756).
resultsFrom 28 meta-analyses, 39 RCTs (n = 20,285; 2,662 patients with MRSA-confirmed SSTI receiving alternative agents and 2,322 receiving vancomycin) were included. No significant difference in clinical success was observed between groups (RR: 1.012, 95% CI: 0.992-1.032; prediction interval: 0.994-1.030). Although alternatives showed modestly higher microbiological success (RR: 1.058, 95% CI 1.001-1.119; prediction interval: 0.895-1.250), the effect lost significance after publication bias adjustment. Alternative agents had significantly lower dermatologic but higher gastrointestinal and hematological risk. Tigecycline had higher adverse events (RR: 1.090, 95% CI: 1.019-1.166), and telavancin had higher drug discontinuation (RR: 1.405, 95% CI: 1.105-1.786).
conclusionDespite the growth of newer anti-MRSA agents, vancomycin remains clinically comparable for MRSA-confirmed SSTI, with apparent microbiological advantages of alternatives tempered by potential publication bias. Varying safety and pharmacological profiles of these agents emphasize the importance of individualized treatment selection.
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