A RANDOMIZED DOUBLE-BLIND TRIAL OF VANCOMYCIN VERSUS TEICOPLANIN FOR THE TREATMENT OF GRAM-POSITIVE BACTEREMIA IN PATIENTS WITH CANCER

In a prospective, randomized, double-blind study comparing teicoplanin and vancomycin for the treatment of gram-positive bacteremias in neut ropenic patients, teicoplanin was given at 6 mg/kg of body weight ever y 24 h intravenously (iv) after initial loading every 12 h for three d oses, while vancomycin was administered at 15 mg/kg every 12 h iv. At enrollment, both groups were comparable in age, sex, underlying hemato logic or neoplastic disorder, baseline renal functions, and incidence of neutropenia. Treatment was successful in 19 (90%) of 21 patients wh o received teicoplanin and 24 (96%) of 25 who received vancomycin (P=. 58). Adverse reactions occurred more often in the vancomycin group (31 %) than in the teicoplanin group (9%; P=.06) and were primarily cutane ous or gastrointestinal. In conclusion, teicoplanin was better tolerat ed than vancomycin, and no statistically significant difference in eff icacy was detected with the sample size in this study.