Comparative Efficacy and Safety of Vancomycin versus Teicoplanin in Patients with Healthcare-associated Methicillin-resistant Staphylococcus aureus Bacteremia: A Multi-center Prospective Observational Study.

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Comparative Efficacy and Safety of Vancomycin versus Teicoplanin in Patients with Healthcare-associated Methicillin-resistant Staphylococcus aureus Bacteremia: A Multi-center Prospective Observational Study.

Antimicrob Agents Chemother. 2013 Oct 28;

Authors: Yoon YK, Park DW, Sohn JW, Kim H, Kim YS, Lee CS, Lee MS, Ryu SY, Jang HC, Choi YJ, Kang CI, Choi HJ, Lee SS, Kim SW, Kim SI, Kim ES, Kim JY, Yang KS, Peck KR, Kim MJ

Abstract
The purpose of this study was to compare the clinical efficacy and safety of vancomycin vs teicoplanin for the treatment of adult patients with healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) bacteremia. A multi-center observational study was prospectively conducted in 15 teaching hospitals in Korea between February 2010 and July 2011. Adult patients (≥18 years) with HA-MRSA bacteremia who were initially treated with vancomycin (n = 134) or teicoplanin (n = 56) were enrolled. Clinical and microbiological responses and drug-related adverse events were compared between the 2 treatment groups using univariate and multivariate logistic regression analyses. The vancomycin or teicoplanin minimum inhibitory concentrations (MIC) were determined by E-test. The MRSA-related mortality, duration of fever, and duration of MRSA bacteremia between the 2 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 0.5 to 2 μg/mL (both MIC50 and MIC90, 1.5 μg/mL), and the TEC MIC ranged 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.

PMID: 24165181 [PubMed - as supplied by publisher]

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