Teicoplanin in the treatment of serious infection

The merits and dosing regimens for teicoplanin in the treatment of endocarditis, bacteremia, bone and joint infections, pediatric use, non in-patient use and in the ICU are discussed. Teicoplanin has several advantages over vancomycin in the treatment of serious infections: long half-life, lower nephrotoxicity, and lack of requirement for serum assays. The recommended regimen for teicoplanin is three loading doses of 6 mg/kg (400 mg) q12h, then 6 mg/kg (400 mg) q24h. There is no significant difference in efficacy between teicoplanin and vancomycin when at least 6 mg/kg teicoplanin is used or, in the case of staphylococcal endocarditis, it is given in combination with another antimicrobial. Teicoplanin is effective and safe in staphylococcal infections including endocarditis, osteomyelitis and septic arthritis. The once daily or alternate daily dosage allows home administration of treatment of infections caused by Staphylococcus aureus, including methicillin-resistant strains and enterococci with appreciable savings in hospital costs and improvement in the quality of life.