 U.S. guidelines recommend either linezolid or vancomycin as the first @-@ line treatment for hospital @-@ acquired ( nosocomial ) MRSA pneumonia . Some studies have suggested that linezolid is better than vancomycin against nosocomial pneumonia , particularly ventilator @-@ associated pneumonia caused by MRSA , perhaps because the penetration of linezolid into bronchial fluids is much higher than that of vancomycin . Several issues in study design have been raised , however , calling into question results that suggest the superiority of linezolid . Regardless , linezolid 's advantages include its high bioavailability ( because it allows easy switching to oral therapy ) , and the fact that poor kidney function is not an obstacle to use ( whereas achieving the correct dosage of vancomycin in patients with renal insufficiency is very difficult ) . 
