Comparative study of teicoplanin vs vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia

Cheng Yi Liu, Wen Sen Lee, Chang Phone Fung, Nai Cheng Cheng, Cheng Long Liu, Su Pen Yang, Shu Liang Chen

Research output: Contribution to journalArticle

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Abstract

Forty patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia were randomised to receive either teicoplanin or vancomycin therapy to compare the clinical efficacy and safety of these glycopeptides. Treatment was successful in 17 (85%) of 20 patients who were randomised to the teicoplanin group, with 6 cures and 11 improvements, and in 15 (75%) of 20 patients randomised to the vancomycin group, with 8 cures and 7 improvements (p = 0.69). Microbiologically, all MRSA pathogens isolated were susceptible to both glycopeptides by the disc diffusion test. The mean zone of inhibition for teicoplanin was 18 ± 2mm (range 16 to 20mm) and 20 ± 2 mm (range 16 to 24mm) for vancomycin. The minimum inhibitory concentration required to inhibit the growth of 90% of organisms in culture (MIC90) for all MRSA isolates was 2.0 mg/L (range 0.5 to 4 mg/L) for teicoplanin and 2.0 mg/L (range 0.5 to 2 mg/L) for vancomycin. The microbiological eradication rate was 85% (17 of 20 isolates) for teicoplanin and 75% (15 of 20 isolates) for vancomycin. None of the failures were due to the emergence of resistant pathogens. Adverse reactions occurred in 19% of patients treated with teicoplanin and 60% of patients treated with vancomycin. There was no significant difference in the occurrence of skin rash (p = 0.60) or in elevation of aminotransferase (p = 0.18). However, nephrotoxicity was significantly greater in the vancomycin group than in the teicoplanin group (50 vs 9.5%, p <0.05). In conclusion, the results of this study demonstrate that teicoplanin appears to be a valuable alternative to vancomycin because it is as efficacious as vancomycin, has fewer adverse reactions, and is conveniently administered.

Original languageEnglish
Pages (from-to)80-87
Number of pages8
JournalClinical Drug Investigation
Volume12
Issue number2
Publication statusPublished - 1996
Externally publishedYes

Fingerprint

Teicoplanin
Vancomycin
Methicillin-Resistant Staphylococcus aureus
Bacteremia
Therapeutics
Glycopeptides
Microbial Sensitivity Tests
Transaminases
Exanthema
Safety

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Comparative study of teicoplanin vs vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia. / Liu, Cheng Yi; Lee, Wen Sen; Fung, Chang Phone; Cheng, Nai Cheng; Liu, Cheng Long; Yang, Su Pen; Chen, Shu Liang.

In: Clinical Drug Investigation, Vol. 12, No. 2, 1996, p. 80-87.

Research output: Contribution to journalArticle

Liu, Cheng Yi ; Lee, Wen Sen ; Fung, Chang Phone ; Cheng, Nai Cheng ; Liu, Cheng Long ; Yang, Su Pen ; Chen, Shu Liang. / Comparative study of teicoplanin vs vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia. In: Clinical Drug Investigation. 1996 ; Vol. 12, No. 2. pp. 80-87.
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abstract = "Forty patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia were randomised to receive either teicoplanin or vancomycin therapy to compare the clinical efficacy and safety of these glycopeptides. Treatment was successful in 17 (85{\%}) of 20 patients who were randomised to the teicoplanin group, with 6 cures and 11 improvements, and in 15 (75{\%}) of 20 patients randomised to the vancomycin group, with 8 cures and 7 improvements (p = 0.69). Microbiologically, all MRSA pathogens isolated were susceptible to both glycopeptides by the disc diffusion test. The mean zone of inhibition for teicoplanin was 18 ± 2mm (range 16 to 20mm) and 20 ± 2 mm (range 16 to 24mm) for vancomycin. The minimum inhibitory concentration required to inhibit the growth of 90{\%} of organisms in culture (MIC90) for all MRSA isolates was 2.0 mg/L (range 0.5 to 4 mg/L) for teicoplanin and 2.0 mg/L (range 0.5 to 2 mg/L) for vancomycin. The microbiological eradication rate was 85{\%} (17 of 20 isolates) for teicoplanin and 75{\%} (15 of 20 isolates) for vancomycin. None of the failures were due to the emergence of resistant pathogens. Adverse reactions occurred in 19{\%} of patients treated with teicoplanin and 60{\%} of patients treated with vancomycin. There was no significant difference in the occurrence of skin rash (p = 0.60) or in elevation of aminotransferase (p = 0.18). However, nephrotoxicity was significantly greater in the vancomycin group than in the teicoplanin group (50 vs 9.5{\%}, p <0.05). In conclusion, the results of this study demonstrate that teicoplanin appears to be a valuable alternative to vancomycin because it is as efficacious as vancomycin, has fewer adverse reactions, and is conveniently administered.",
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