Abstract:Objective To compare the effectiveness, safety, and economy between vancomycin and linezolid in the treatment of suppurative spondylitis. Methods Medical records of 120 patients with suppurative spondylitis and treated with vancomycin or linezolid in the orthopedic department of a tertiary hospital from January 2019 to December 2022 were retrospectively analyzed. 71 patients were treated with vancomycin (vancomycin group) and 49 with linezolid (linezolid group). Data about inflammatory indicators, adverse reactions as well as treatment time and total cost of antimicrobial agents were collected, the effectiveness, safety, and economy of two groups of patients were compared. Results The white blood cell count (WBC), C-reactive protein (CRP), pain visual analogue scale (VAS), and Oswestry disability index (ODI) of patients in vancomycin and linezolid groups after treatment were all lower than before, with statistically significant differences (all P < 0.05). There were no statistically significant differences in the above indicators, treatment time and adverse reaction incidence of antimicrobial treatment between the two groups after treatment (all P>0.05). While the total cost of antimicrobial treatment in linezolid group was lower than that in vancomycin group, with a statistically significant difference (P < 0.05). Conclusion The effectiveness and safety of linezolid in the treatment of suppurative spondylitis are comparable to vancomycin, but the economy is superior to vancomycin.