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

Young Kyung Yoon, Dae Won Park, Jang Wook Sohn, Hyo Youl Kim, Yeon Sook Kim, Chang Seop Lee, Mi Suk Lee, Seong Yeol Ryu, Hee Chang Jang, Young Ju Choi, Cheol In Kang, Hee Jung Choi, Seung Soon Lee, Shin Woo Kim, Sang Il Kim, Eu Suk Kim, Jeong Yeon Kim, Kyung Sook Yang, Kyong Ran Peck, Min Ja Kim

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24 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)317-324
Number of pages8
JournalAntimicrobial Agents and Chemotherapy
Volume58
Issue number1
DOIs
Publication statusPublished - 2014 Jan

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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    Yoon, Y. K., Park, D. W., Sohn, J. W., Kim, H. Y., Kim, Y. S., Lee, C. S., Lee, M. S., Ryu, S. Y., Jang, H. C., Choi, Y. J., Kang, C. I., Choi, H. J., Lee, S. S., Kim, S. W., Kim, S. I., Kim, E. S., Kim, J. Y., Yang, K. S., Peck, K. R., & Kim, M. J. (2014). 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. Antimicrobial Agents and Chemotherapy, 58(1), 317-324. https://doi.org/10.1128/AAC.00520-13