Teicoplanin as an anti-methicillin resistant Staphylococcus aureus agent in infections of severely poisoned intensive care unit patients/ Tehran- Iran.
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is related to high morbidity and mortality. Glycopeptide antibiotic is the choice of treatment in MRSA infections. Teicoplanin is a semi synthetic glycopeptide antibiotic with a spectrum of activity similar to vancomycin.  Our objective is the evaluation of efficacy and safety of Teicoplanin in MRSA infections among severely poisoned intensive care unit (ICU) patients.


METHODS
During a 6 months period, in a prospective cross sectional study 54 eligible patients from 80 clinically suspicious with MRSA infections were recruited. The efficacy and safety of Teicoplanin was evaluated 5 times. The clinical findings, laboratory data, and bacteriologic responses were defined as cure, improvement and failure.


RESULTS
The mean age of the patients was 36.3 years (range, 20-72, SD = 13.3). 75.9% were male. Suicidal attempts were recorded in 63%. The most common poisoning was TCAs, BZDs, tramadol and opium. 94.4% were unconscious and under mechanical ventilation. Tracheal cultures were positive in 98.1% by VAP diagnosis. Length of stay in the ICU was between  4-54 days. Total clinical effectiveness was 90.4%, and failure 9.6%. Mortality rate of the patient, was 9/54 (16.6 %) which 3 of them were for lack of a clinical response. On the fourth visit, the adverse effects included: rash (11.10%), anemia (36.17%), nephrotoxicity (17.02%) and thrombocytopenia &lt; 150000 (100%). Other side effects such as: leucopenia, severe thrombocytopenia (&lt; 50000), pancytopenia and red man syndrome were not detected.


CONCLUSIONS
Teicoplanin is suggestible for MRSA infections among severely poisoned patients according to its efficacy, safety, half life and tolerance.
Alireza
A
Salimi
Haleh
H
Talaie
Mohsen
M
Rezaie Hemami
Arezou
A
Mahdavinejad
Behjat Barari
BB
Barari
Parmis
P
Razi
Department of Microbiology, Islamic Azad University , Fars Science and Research Branch, Shiraz-Iran. s.kamalbeik@gmail.com.
Sepideh
S
Kamalbeik
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007492:Iran / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D011041:Poisoning / Q000453:epidemiology*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013406:Suicide, Attempted; D017334:Teicoplanin / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D017334:Teicoplanin