Comparison of vancomycin and teicoplanin trough serum levels in patients with infected orthopedic devices: new data for old therapies.
We compared retrospectively vancomycin and teicoplanin trough serum levels after loading doses and, subsequently, after high daily doses, in 52 patients (26 in each group) who had developed infections after implantation of an orthopedic device. The target trough serum level was > 25 mg/l. Trough levels were significantly higher at 2 days (±1) and 5 days (±1) in patients who received teicoplanin compared with patients who received a continuous perfusion of vancomycin (26.1 vs. 16 mg/l at day 2 ± 1, P = 0.01; 27.8 vs. 19.9 mg/l at day 5 ± 1, P = 0.01). One of the 26 patients taking vancomycin reached the target trough serum level by day 2 (±1), whereas 10 of the 26 patients taking teicoplanin reached the target by that time (P = 0.002). At day 5 (±1), 6/26 patients taking vancomycin reached the target, versus 13/26 patients taking teicoplanin (P = 0.04). However, physicians should remain cautious when administering teicoplanin empirically because of the higher MIC₉₀ values observed for coagulase-negative staphylococci compared with vancomycin.
Infectious Diseases Department, Dron Hospital, 135 Rue du Président Coty, 59200 Tourcoing, France. xljhe@yahoo.fr
Xavier
X
Lemaire
Caroline
C
Loiez
Michel
M
Valette
Henri
H
Migaud
Luc
L
Dubreuil
Yazdan
Y
Yazdanpanah
Eric
E
Senneville
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000097:blood* / Q000188:drug therapy; D012189:Retrospective Studies; D017334:Teicoplanin / Q000008:administration & dosage / Q000097:blood*; D014640:Vancomycin / Q000008:administration & dosage / Q000097:blood*
D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin