TEICOPLANIN - A PHARMACOECONOMIC EVALUATION OF ITS USE IN THE TREATMENT OF GRAM-POSITIVE INFECTIONS

Teicoplanin, a glycopeptide antibiotic, is active against Gram-positiv e organisms, including methicillin-resistant staphylococci. It has dem onstrated similar efficacy to vancomycin in the treatment of Gram-posi tive infections in febrilepatients with neutropenia; fewer comparative data are available in patients with other infection types. Compared w ith vancomycin, teicoplanin is associated with less nephrotoxicity, ap pears to cause fewer anaphylactoid reactions, requires less monitoring and is more convenient to administer (once daily by intravenous bolus or intramuscular injection vs 2 to 4 times daily by intravenous infus ion). Two European cost-minimisation studies have demonstrated that wh ile the acquisition cost per dose of teicoplanin was approximately twi ce that of vancomycin, the cost of 2 weeks' therapy with either agent was similar (difference of 1 to 2%). However in order to fully explore potential differences between these agents, a full economic analysis which considers all treatment-related costs is needed. Home therapy of Gram-positive infections, a setting bl which teicoplanin may be prefe rred over vancomycin because of its tolerability profile and ease of a dministration, is particularly worthy of future economic study. Thus, there are a number of areas needing further study before the optimum f ormulary positioning of teicoplanin can be definitely stated. Neverthe less, present evidence suggests that teicoplanin is likely to have pha rmacoeconomic advantages over vancomycin in at least some situations.