Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis

Int J Antimicrob Agents. 2009 Nov;34(5):482-5. doi: 10.1016/j.ijantimicag.2009.06.020. Epub 2009 Aug 26.

Abstract

The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (P=0.06). In the Cox regression analysis, fever beyond 48 h of treatment was a significant predictor of treatment failure (P=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after beginning antimicrobial lock therapy was associated with treatment failure.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Biofilms / drug effects
  • Catheter-Related Infections / drug therapy*
  • Coagulase / biosynthesis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Staphylococcal Infections / drug therapy*
  • Staphylococcus / drug effects*
  • Survival Analysis
  • Teicoplanin / administration & dosage
  • Teicoplanin / therapeutic use*
  • Treatment Outcome
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Coagulase
  • Teicoplanin
  • Vancomycin