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Treatment of bone and soft tissue infections with teicoplanin
P Marone1, E Concia, M Andreoni
1Institute of Infectious Diseases, University of Pavia, IRCCS S. Matteo, Italy.
Abstract:
The use of teicoplanin was evaluated in a group of 33 patients, which included 18 prosthetic infections, seven with osteomyelitis, five skin and soft tissue infections, and three cases of septic arthritis. The bacterial pathogens isolated were 27 isolates of Staphylococcus aureus (methicillin sensitive 18; methicillin resistant 9), Staph. hominis (2), Staph. epidermidis (1), Staph. haemolyticus (2), Enterococcus faecalis (1), Streptococcus pyogenes (1), Peptococcus spp. (1). Eleven patients had polymicrobial infections (Gram-positive plus Gram-negative and/or anaerobic bacteria). In ten cases (nine polymicrobial infections) teicoplanin was used in combination with other antibiotics. Teicoplanin was administered intravenously 400 mg every 24 h in 26 cases, 200 mg every 24 h in six cases and 600 mg every 24 h in one case. The duration of the treatment ranged from 9 to 73 days with a mean of 27.3. Efficacy was evaluable in 30 patients, because in three patients treatment was stopped because of adverse reactions. Cure or improvement was noted in 28 patients (93%). Bacteriological cure occurred in 25 patients (83.3%).
Insights
Teicoplanin demonstrated high efficacy in treating various bacterial infections, including prosthetic joint infections and osteomyelitis. The antibiotic achieved a 93% clinical cure or improvement rate in evaluable patients.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Microbiology
Background:
- Teicoplanin is a glycopeptide antibiotic used for serious Gram-positive bacterial infections.
- Evaluating teicoplanin's effectiveness in diverse clinical settings is crucial for treatment guidelines.
Purpose of the Study:
- To assess the clinical efficacy and outcomes of teicoplanin in patients with challenging bacterial infections.
- To analyze the spectrum of pathogens and treatment responses associated with teicoplanin therapy.
Main Methods:
- A retrospective analysis of 33 patients treated with teicoplanin for infections including prosthetic infections, osteomyelitis, skin/soft tissue infections, and septic arthritis.
- Bacterial pathogens were identified, and teicoplanin was administered intravenously at various dosages (200-600 mg/day).
- Treatment duration ranged from 9 to 73 days, with efficacy evaluated in 30 patients.
Main Results:
- Teicoplanin was effective against Staphylococcus aureus (methicillin-sensitive and resistant strains), with 93% of evaluable patients showing cure or improvement.
- Bacteriological cure was achieved in 83.3% of patients.
- Common indications included prosthetic infections (18 patients) and osteomyelitis (7 patients).
Conclusions:
- Teicoplanin is a highly effective antibiotic for treating serious Gram-positive bacterial infections, including complex cases like prosthetic infections and osteomyelitis.
- The drug exhibits a favorable efficacy profile with a high rate of clinical and bacteriological cure.
- Further research may explore optimal dosing and combination therapies involving teicoplanin.