Spanish experience with teicoplanin

Abstract

Teicoplanin, a narrow spectrum glycopeptide antibiotic was prospectively evaluated in an open, non-comparative manner in three Spanish university hospitals. A total of 65 patients were treated (25 females and 40 males: median age 45 years) for the following severe infections: endocarditis (5), bone and joint (9), lower respiratory (6), septicaemia (21), skin and soft tissue (13) and other miscellaneous infections (11). The median dose given was 6.8 mg/kg (range 1.0-15.1 mg/kg), for a median duration of 12 days. A total of 70 organisms were isolated, of which the most common was Staphylococcus aureus, followed by coagulase-negative staphylococci. Of these 70 organisms, 44 were eliminated by teicoplanin therapy, while 10 organisms persisted. Clinical cure was considered to have been achieved in 75% of patients, while 11% showed some improvement, leaving 11% in whom therapy had failed. The safety of teicoplanin was considered to be acceptable, only 16 out of 65 patients experiencing one or more adverse events. Of 23 adverse events, two were described as severe, the remainder being either moderate or mild. No effects due to age or dose on the safety of teicoplanin were noted. These results are in keeping with those previously reported by other groups in Western Europe, and confirm the good safety profile of teicoplanin at a dose of 6 mg/kg. Further studies are now needed to compare teicoplanin with standard antibiotic regimens.