title: Randomized comparison trial of teicoplanin i.v., teicoplanin i.m., and cefazolin therapy for skin and soft tissue infections caused by gram-positive bacteria.
abstract: Teicoplanin, a glycopeptide antibiotic chemically related to the vancomycin-ristocetin group of antibiotics, has potent activity against aerobic and anaerobic gram-positive bacteria. In this study, we examined the efficacy and safety of teicoplanin for parenteral treatment of skin and soft tissue infections caused by gram-positive bacteria. Ninety-six hospitalized adults with moderate to severe skin and soft tissue infections were randomized to receive either teicoplanin intravenously (i.v.) once a day, teicoplanin intramuscularly (i.m.) once a day, or cefazolin i.v. every 8 hours. We evaluated patients' clinical and microbiologic status and assessed clinical and laboratory adverse events. Of 76 clinically assessable patients, 26 of 26 (100%) given teicoplanin i.v., 21 of 22 (95%) given teicoplanin i.m., and 26 of 28 (93%) given cefazolin showed improvement or cure. Of 60 microbiologically assessable patients, 22 of 22 (100%) given teicoplanin i.v., 16 of 18 (89%) given teicoplanin i.m, and 18 of 20 (90%) given cefazolin were cured. Of 96 patients assessable for adverse events, 7 of 34 (21%) given teicoplanin i.v., 4 of 31 (13%) give teicoplanin i.m., and 1 of 31 (3%) given cefazolin had adverse events. In this study, once daily teicoplanin appeared to be safe and effective therapy for skin and soft tissue infections.
authors.affiliation: Medical Service, Veterans Administration Medical Center, Martinez, CA 94553.
authors.forename: V A
authors.initials: VA
authors.lastname: Chirurgi
authors.forename: H
authors.initials: H
authors.lastname: Edelstein
authors.forename: S E
authors.initials: SE
authors.lastname: Oster
authors.forename: R
authors.initials: R
authors.lastname: Karp
authors.forename: K B
authors.initials: KB
authors.lastname: Cassano
authors.forename: S
authors.initials: S
authors.lastname: Aiken
authors.forename: R E
authors.initials: RE
authors.lastname: McCabe
mesh_terms: D002437:Cefazolin / Q000009:adverse effects / Q000627:therapeutic use*; D003240:Connective Tissue Diseases / Q000188:drug therapy*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D017334:Teicoplanin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D017334:Teicoplanin; D002437:Cefazolin