Teicoplanin in the treatment of gram-positive-bacterial endocarditis.
Intravenous teicoplanin has been used to treat 23 cases of gram-positive-bacterial endocarditis, usually with 3 to 7 mg/kg every 12 h on the first day, followed by 3 to 7 mg/kg every 24 h. For some cases (staphylococcal and enterococcal endocarditis), the dosage was 8 to 14.4 mg/kg per day and/or other antibiotics were given. The mean duration was 48.2 days (range, 23 to 130 days). Of 23 patients, 21 (91.3%) had negative cultures or were cured. A total of 18 patients were treated with teicoplanin alone; of these, 4 had surgery, and all (except 2 who relapsed) were cured. Teicoplanin was combined with one or more antibiotics in five cases; in all cases appropriate cultures were negative, but three patients died during therapy or follow-up. Mild renal impairment was seen in two patients; both were receiving teicoplanin in combination with an aminoglycoside. We conclude that intravenous teicoplanin administered once a day at doses of 7 to 14 mg/kg per day is well tolerated, easy to administer, and may represent an efficacious therapy for gram-positive-bacterial endocarditis.
Martino
P
P
Cattedra di Ematologia, Dipartimento di Biopatologia Umana, Rome, Italy.
Venditti
M
M
Micozzi
A
A
Brandimarte
C
C
Gentile
G
G
Santini
C
C
Serra
P
P
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D013293:Enterococcus faecalis; D005260:Female; D006020:Glycopeptides / Q000493:pharmacokinetics / Q000627:therapeutic use; D006094:Gram-Positive Bacteria; D006801:Humans; D008297:Male; D008875:Middle Aged; D013211:Staphylococcus aureus; D013291:Streptococcus; D017334:Teicoplanin; D013997:Time Factors
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D017334:Teicoplanin