title: Multicenter prospective observational study of the comparative efficacy and safety of vancomycin versus teicoplanin in patients with health care-associated methicillin-resistant Staphylococcus aureus bacteremia.
abstract: The purpose of this study was to compare the clinical efficacy and safety of vancomycin to those of teicoplanin for the treatment of adult patients with health care-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) bacteremia. A multicenter observational study was prospectively conducted in 15 teaching hospitals in Korea between February 2010 and July 2011. Adult patients (≥18 years old) with HA-MRSA bacteremia who were initially treated with vancomycin (VAN) (n = 134) or teicoplanin (TEC) (n = 56) were enrolled. Clinical and microbiological responses and drug-related adverse events were compared between the two treatment groups using univariate and multivariate logistic regression analyses. The vancomycin and teicoplanin MICs were determined by Etest. The MRSA-related mortality, duration of fever, and duration of MRSA bacteremia in the treatment groups were not significantly different. There was no significant difference in the occurrence of drug-related adverse events. Among the 190 MRSA isolates, the VAN MICs ranged from 0.5 to 2 μg/ml (MIC50 and MIC90, 1.5 μg/ml), and the TEC MIC ranged from 0.5 to 8 μg/ml (MIC50, 3 μg/ml; MIC90, 6 μg/ml). In multivariate analyses, the antibiotic type (vancomycin or teicoplanin) was not associated with treatment outcomes. This study indicates that teicoplanin is an effective and safe alternative to vancomycin for the treatment of HA-MRSA bacteremia.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Kyung
authors.initials: YK
authors.lastname: Yoon
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Park
authors.forename: Jang Wook
authors.initials: JW
authors.lastname: Sohn
authors.forename: Hyo Youl
authors.initials: HY
authors.lastname: Kim
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Chang-Seop
authors.initials: CS
authors.lastname: Lee
authors.forename: Mi Suk
authors.initials: MS
authors.lastname: Lee
authors.forename: Seong-Yeol
authors.initials: SY
authors.lastname: Ryu
authors.forename: Hee-Chang
authors.initials: HC
authors.lastname: Jang
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Choi
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Choi
authors.forename: Seung Soon
authors.initials: SS
authors.lastname: Lee
authors.forename: Shin Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Kyung Sook
authors.initials: KS
authors.lastname: Yang
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Min Ja
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D008826:Microbial Sensitivity Tests; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D017334:Teicoplanin / Q000627:therapeutic use; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin