[Glycopeptides (vancomycin, teicoplanin)--their place in the antibacterial therapy of patients in a high-risk group]

Abstract

Today, when the number of high-risk patients is increasing, special attention should be paid to polyresistant gram-positive microorganisms staphylococci and enterococci, whose role in infective complications and septic states is increasing. The author analyzes published reports on the rate of isolation of methicillin-resistant staphylococci (MRS) and enterococci in different countries and relationship of this parameter with antibiotic policy. Special attention is paid to unjustified wide use of third-generation cephalosporines and their role in selection of polyresistant bacteria. The rate of MRS isolation vs. all other staphylococci at intensive care wards for newborns is as high as 63.9%. The incidence of coagulase-negative staphylococci (most often S. epidermidis) in clinical material (blood, cerebrospinal fluid, urine) from high-risk patients increased 2-3 times during two recent years. Glycopeptides vancomycin and teicoplanine are drugs of choice for the treatment of infections caused by such microorganisms (sepsis, endocarditis, osteomyelitis, pneumonia, etc.). These drugs should be listed among obligatory antibiotics for resuscitation and intensive care wards as life-saving drugs.