THE COMPARATIVE EFFICACY AND SAFETY OF TEICOPLANIN AND VANCOMYCIN

Glycopeptide antibiotics, such as teicoplanin and vancomycin, are acti ve against staphylococci (including methicillin resistant strains), st reptococci, enterococci and Clostridium spp. Vancomycin and teicoplani n are both widely used in the treatment of infections caused by Gram-p ositive organisms. Vancomycin can, however, provoke a number of side-e ffects, and serum concentrations should be monitored during treatment. Teicoplanin has a longer half-life than vancomycin, it can be given a s an intravenous bolus or by intramuscular injection, and nephrotoxici ty and ototoxicity are relatively uncommon. Treatment with teicoplanin might, therefore, offer advantages over treatment with vancomycin-pro vided that similar clinical efficacy can be shown. At least 11 clinica l trials comparing the efficacy and safety of teicoplanin and vancomyc in have been carried out worldwide. Meta-analysis of the combined resu lts from these studies indicates that more than three-quarters of the patients in each of the treatment groups had a clinical response to th erapy. Meta-analysis of the numbers of adverse events occurring in eac h treatment group shows significantly fewer reports of adverse events in patients receiving teicoplanin (13.9%) than in those receiving vanc omycin (21.9%). Direct comparisons are difficult because of inherent d ifferences between studies, but available data suggest that teicoplani n is as effective as vancomycin and that its superior tolerability tog ether with advantages such as once-daily bolus administration, intramu scular use and lack of requirement for routine serum monitoring, give it considerable potential for use in clinical practice.