Health Technology Assessment of Oxazolidinones for MRSA-Associated Complicated Skin and Soft Tissue Infections

Yucheng Zhao, Baisen Huang, Zunchang Yang, Hongjie Kuang, Jisheng Chen Key Specialty of Clinical Pharmacy, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, People’s Republic of ChinaCorrespondence: Jisheng Chen, Key Specialty of Clinical Pharmacy, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China, Tel +86 020-87622305, Email cjslym@163.comPurpose: This study aims to provide a reference for the introduction and utilization of oxazolidinone drugs in medical institutions, based on the authoritative Chinese guideline, Rapid Guideline for Drug Evaluation and Selection in Chinese Medical Institutions (2nd Edition) (Rapid Guideline).Patients and Methods: Based on the Rapid Guideline, this study conducted a comprehensive literature search across relevant databases, including the China National Knowledge Infrastructure (CNKI), PubMed, Embase, and the Cochrane Library, as well as drug labels and relevant clinical guidelines. A health technology assessment (HTA) was then performed on three oxazolidinone drugs across five dimensions: pharmaceutical properties, efficacy, safety, economy, and other attributes.Results: The final evaluation results from highest to lowest were tedizolid (83.52 points), linezolid (80.02 points), and contezolid (72.79 points). The evaluation results of tedizolid across the five dimensions were as follows: pharmaceutical properties (25.5 points), efficacy (25 points), safety (17.5 points), economy (9.02 points), and other attributes (6.5 points). For linezolid, the scores were pharmaceutical properties (25 points), efficacy (25 points), safety (18 points), economy (5.02 points), and other attributes (7 points). For contezolid, the scores were pharmaceutical properties (24 points), efficacy (22 points), safety (18.5 points), economy (4.29 points), and other attributes (4 points).Conclusion: Based on the comprehensive evaluation across five key dimensions, the recommended prioritization of oxazolidinone antibiotics is as follows: tedizolid, linezolid, and contezolid. The ranking was primarily driven by tedizolid’s once-daily dosing and lowest total course cost, linezolid’s pediatric indication and widespread availability, and contezolid’s superior safety profile, although its overall score was limited by higher cost and lack of guideline recommendations. This study recommends the selection of tedizolid, linezolid, and contezolid for use in medical institutions during the introduction and application of oxazolidinone antibiotics.Keywords: oxazolidinone drugs, complicated SSTIs, MRSA, health technology assessment