{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:33:12Z","timestamp":1792078392481,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","award":["NRF\u20102021R1A6A1A03044296"],"award-info":[{"award-number":["NRF\u20102021R1A6A1A03044296"]}],"id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To summarize the evidence on the efficacy and safety of vancomycin compared with those of alternative treatments in adult patients with methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Embase, and Web of Science were searched up to December 15, 2023, for systematic reviews and meta\u2010analyses comparing vancomycin with alternative MRSA treatments. Primary outcomes included clinical cure and microbiological eradication rates. Organ\u2010specific safety outcomes were assessed. Summary estimates were recalculated using a random\u2010effects model. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. This study was registered in PROSPERO (CRD42022340359).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This umbrella review included 19 studies and 71 meta\u2010analyses (46 efficacy and 25 safety) comparing vancomycin with 10 alternative treatments across different MRSA infection types and populations. GRADE assessment showed that 29.58% of the meta\u2010analyses were of high quality. Linezolid and daptomycin showed higher efficacy in MRSA\u2010induced skin and soft tissue infections and pneumonia (moderate evidence quality) and bacteremia (very low evidence quality), respectively, compared with that of vancomycin. Cephalosporins had a higher risk of nausea, whereas linezolid had a higher risk of nausea, diarrhea, and thrombocytopenia than that of vancomycin. Vancomycin posed a higher risk of rash, pruritus, red man syndrome, and nephrotoxicity than that of alternatives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The quality of evidence supporting the higher efficacy of alternative treatment over vancomycin for MRSA infection was not high. Given varying safety profiles and advancements in therapeutic monitoring, careful consideration of patient\u2010specific factors and pharmacokinetics is crucial when selecting treatment alternatives to vancomycin.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jebm.12644","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T05:28:33Z","timestamp":1727760513000},"page":"729-739","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Efficacy and safety of vancomycin compared with those of alternative treatments for methicillin\u2010resistant <i>Staphylococcus aureus<\/i> infections: An umbrella review"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-915X","authenticated-orcid":false,"given":"Sujata","family":"Purja","sequence":"first","affiliation":[{"name":"Data Science Evidence\u2010Based and Clinical Research Laboratory Department of Health, Social, 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