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Teicoplanin in endocarditis: a multicentre, open European study
Chemotherapy
|September 1, 1995
Summary
Teicoplanin combination therapy shows higher success rates for Staphylococcus aureus endocarditis compared to monotherapy. This glycopeptide antibiotic is effective for streptococcal and enterococcal endocarditis, with combination therapy recommended for S. aureus cases.
Area of Science:
- Infectious Diseases
- Pharmacology
- Cardiology
Background:
- The clinical efficacy of teicoplanin, a glycopeptide antibiotic, for treating endocarditis remains debated.
- Previous clinical trials have shown varying results between US and European regimens.
Purpose of the Study:
- To evaluate the outcomes, efficacy, and safety of teicoplanin monotherapy versus combination therapy.
- To specifically assess teicoplanin's effectiveness in Staphylococcus aureus endocarditis cases.
Main Methods:
- A retrospective study involving 115 patients across 29 European centers.
- Patients typically had mixed endocarditis and were intolerant of prior antibiotic treatments.
- Comparison of monotherapy versus combination therapy outcomes for native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE).
Main Results:
- Combination therapy demonstrated higher success rates than monotherapy for NVE (93% vs. 85%) and S. aureus NVE (84% vs. 50%).
- Similar efficacies were observed for PVE (75% vs. 79%), but combination therapy was superior for S. aureus PVE (100% vs. 67%).
- Adverse events related to teicoplanin occurred in 19% of patients, leading to therapy termination in 9%.
Conclusions:
- Teicoplanin is effective in monotherapy or combination therapy for streptococcal endocarditis, with aminoglycoside augmentation advised.
- Teicoplanin shows significant efficacy in enterococcal endocarditis, representing a therapeutic advancement.
- Combination therapy appears more successful for S. aureus endocarditis, particularly in prosthetic valve cases.