An audit of efficacy and toxicity of teicoplanin versus vancomycin in febrile neutropenia: is the different toxicity profile clinically relevant?

Infection
C Hahn-AstM Von Lilienfeld-Toal

Abstract

Glycopeptides are often used for persistent fever in neutropenic patients. This study compares efficacy and toxicity of teicoplanin and vancomycin. Hundred consecutive neutropenic patients with hematological malignancies and persistent fever after 72 h of first-line antibiotic therapy (91% piperacillin/tazobactam) were treated with teicoplanin (800 mg on day 1, then 400 mg/day)+piperacillin/tazobactam+gentamicin from 08/96 to 09/00 (group T) or with vancomycin (2 g/day)+meropenem+levofloxacin from 10/00 to 04/02 (group V). Success was defervescence (>or=7 days) in absence of any sign of continuing infection. Nephrotoxicity was monitored daily as increase in serum creatinine. Fifty patients were analyzed in each group. Efficacy was evaluated in patients with piperacillin/tazobactam as first-line therapy only. Treatment was successful in 76% in group T (n=42) and 59% in group V (n=49), p=0.118. Toxicity was evaluated in all patients. The median increase of creatinine was 11% (interquartile range 0%-30%) in group T and 17% (0%-74%) in group V, p=0.062. In patients who received concomitant amphotericin B (given for 7 days and 6 days, respectively, p=0.525), median creatinine increased from 0.9 mg/dl (0.8-1.1) to 1.2 mg/dl (0.9-1.5)...Continue Reading

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Citations

Sep 10, 2013·The Journal of Infection·Philippa C MatthewsMatthew Scarborough
Dec 11, 2013·Journal of Aerosol Medicine and Pulmonary Drug Delivery·Emmanuelle MercierLaurent Vecellio
Jul 12, 2011·Leukemia & Lymphoma·Christos I Kosmidis, Pranatharthi H Chandrasekar
Jan 15, 2016·Expert Opinion on Drug Safety·Matteo Bassetti, Elda Righi
Jan 29, 2011·Internal Medicine Journal·C S TamUNKNOWN Australian Consensus Guidelines 2011 Steering Committee
Dec 18, 2013·British Journal of Clinical Pharmacology·Jason A TrubianoMonica A Slavin
Mar 1, 2011·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Dayana BravoDavid Navarro

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