Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis.
The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (P=0.06). In the Cox regression analysis, fever beyond 48 h of treatment was a significant predictor of treatment failure (P=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after beginning antimicrobial lock therapy was associated with treatment failure.
Del Pozo
J L
JL
Division of Infectious Diseases, Clínica Universidad de Navarra, Pamplona, Spain. delpozo.jose@mayo.edu
García Cenoz
M
M
Hernáez
S
S
Martínez
A
A
Serrera
A
A
Aguinaga
A
A
Alonso
M
M
Leiva
J
J
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy*; D018441:Biofilms / Q000187:drug effects; D055499:Catheter-Related Infections / Q000188:drug therapy*; D003030:Coagulase / Q000096:biosynthesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013210:Staphylococcus / Q000187:drug effects*; D016019:Survival Analysis; D017334:Teicoplanin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D003030:Coagulase; D017334:Teicoplanin; D014640:Vancomycin