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 neutropenic patients, teicoplanin was given at 6 mg/kg of body weight every 24 h intravenously (i.v.) after initial loading every 12 h for three doses, while vancomycin was administered at 15 mg/kg every 12 h i.v. At enrollment, both groups were comparable in age, sex, underlying hematologic or neoplastic disorder, baseline renal functions, and incidence of neutropenia. Treatment was successful in 19 (90%) of 21 patients who 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 cutaneous or gastrointestinal. In conclusion, teicoplanin was better tolerated than vancomycin, and no statistically significant difference in efficacy was detected with the sample size in this study.
Rolston
K V
KV
Department of Medical Specialties, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Nguyen
H
H
Amos
G
G
Elting
L
L
Fainstein
V
V
Bodey
G P
GP
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D017334:Teicoplanin / Q000009:adverse effects / Q000627:therapeutic use*; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use*
D017334:Teicoplanin; D014640:Vancomycin