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A survey of the use of teicoplanin in patients with haematological malignancies and solid tumours

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A significant number of open and comparative studies have now addressed the use of teicoplanin in the treatment of documented or presumed infection in patients with haematological and non-haematological malignancy. Available evidence suggests that teicoplanin is an effective agent against such infections, with an excellent safety profile. The use of teicoplanin and vancomycin may be justified as part of the initial management of clinically infected right atrial catheters in patients with malignancy. The first-line use of glycopeptides may also be appropriate in units where streptococcal and methicillin resistant staphylococcal infections are prevalent. However, such a policy should be reviewed regularly. Except in the above situations, a delay in the introduction of either teicoplanin or vancomycin in cancer patients does not appear to produce any excess mortality, but there may be some additional morbidity in terms of fever and malaise. The introduction of glycopeptides as second-line agents is indicated for sensitive, microbiologically documented infections and for patients who have not responded to empirical, first-line therapy. Non-inpatient treatment with teicoplanin is an area of ongoing interest and may be justified on both humanitarian and pharmacoeconomic grounds. The use of glycopeptides in the prophylactic setting remains controversial and should be avoided while the emergence of resistance, particularly in enterococci, should be monitored closely.

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References

  1. Menichetti, F., Martino, P., Bucaneve, G., D'Antonio, D., Liso, V., Ricci, P., Nosari, A., Buelli, M., Carotenuto, M., Fasola, G., Jacopino, P., Montillo, M., Barbabietola, G., Girmenia, C., Del Favero, A., andThe Gimema Infection Program: Effects of teicoplanin and those of vancomycin in initial empirical antibiotic regimen for febrile neutropenic patients with haematologic malignancies. Antimicrob. Agents Chemother. 38 (1994) 2041–2046.

    CAS  PubMed  Google Scholar 

  2. Rubio, M., Palau, L., Vivas, J., del Potro, E., Diaz-Mediavilla, J., Alvarez, A., Martinez, R., Picazo, J.-J.: Predominance of gram-positive microorganisms is a cause of septicaemia in patients with haematological malignancies. Infect. Control Hosp. Epidemiol. 15 (1994) 101–104.

    Article  CAS  PubMed  Google Scholar 

  3. Kureishi, A., Jewesson, P., Rubinger, M., Cole, C., Reece, D., Phillips, G., Smith, J., Chow, A.: Double blind comparison of teicoplanin versus vancomycin in febrile neutropenic patients receiving concomitant tobramycin and piperacillin: effect on cyclosporin A-associated nephrotoxicity. Antimicrob. Agents Chemother. 35 (1991) 2246–2252.

    CAS  PubMed  Google Scholar 

  4. Wilson, A., Gruneberg, R., Neu, H.: A critical review of the dosage of teicoplanin in Europe and the USA. J. Antimicrob. Chemother. 38 (1996) 507–521.

    Article  Google Scholar 

  5. Editorial: Red men should go: vancomycin and histamine release. Lancet 335 (1990) 1006–1007.

  6. Choi, J., Kim, Y., Shin, W., Kang, M., Kim, D., Min, W., Park, C., Kim, C., Kim, D.: A randomized study comparing clinical efficacy of ceftazidime plus aztreonam plus teicoplanin or vancomycin containing regimen in febrile granulocytopenic patients. J. Korean Soc. Chemother. 10 (1992) 165–171.

    Google Scholar 

  7. Cony-Makhoul, P., Brossard, G., Marit, G., Pellegrin, J., Texier-Maugein, J., Reiffers, J.: A prospective study comparing vancomycin and teicoplanin as second-line empiric therapy for infection in neutropenic patients. Br. J. Haematol. 76 (Suppl. 2) (1990) 35–40.

    Article  PubMed  Google Scholar 

  8. Smith, S., Cheesbrough, J., Spearing, R., Davies, J.: Randomized prospective study comparing vancomycin with teicoplanin in the treatment of infections associated with Hickman catheters. Antimicrob. Agents Chemother. 33 (1989) 1193–1197.

    CAS  PubMed  Google Scholar 

  9. Novakova, I., Donnelly, J., De Pauw, B.: Ceftazidime as monotherapy or combined with teicoplanin for initial empiric treatment of presumed bacteraemia in febrile granulocytopenic patients. Antimicrob. Agents Chemother. 35 (1991) 672–678.

    CAS  PubMed  Google Scholar 

  10. Del Favero, A., Menichetti, F., Guerciolini, R., Bucaneve, G., Baldelli, F., Aversa, F., Terenzi, A., Davis, S., Pauluzzi, S.: Prospective randomised clinical trial of teicoplanin for empiric combined therapy in febrile, granulocytopenic acute leukaemia patients. Antimicrob. Agents Chemother. 31 (1987) 1126–1129.

    PubMed  Google Scholar 

  11. Martino, P., Micozzi, A., Gentile, G., Raccah, R., Girmenia, C., Mandelli, F.: Piperacillin plus amikacin vs piperacillin plus amikacin plus teicoplanin for empirical treatment of febrile episodes in neutropenic patients receiving quinolone prophylaxis. Clin. Infect. Dis. 15 (1992) 290–294.

    CAS  PubMed  Google Scholar 

  12. Meunier, F., Van Der Auwera, P., Aoun, M., Bron, D.: Ceftazidime plus teicoplanin versus ceftazidime plus amikacin as empiric therapy for fever in cancer patients with granulocytopenia. Br. J. Haematol. 76 (Suppl. 2) (1990) 49–53.

    Article  PubMed  Google Scholar 

  13. Micozzi, A., Nucci, M., Venditti, M., Gentile, M., Girmenia, C., Meloni, G., Martino, P.: Piperacillin/tazobactam/amikacin versus piperacillin/amikacin/teicoplanin in the empirical treatment of neutropenic patients. Eur. J. Clin. Microbiol. Infect. Dis. 12 (1993) 1–8.

    Article  CAS  PubMed  Google Scholar 

  14. Micozzi, A., Venditti, M., Amadori, S., Pulsoni, A., Tirindelli, C., Martino, P.: Teicoplanin in the treatment of gram-positive bacteraemia in neutropenic patients. Br. J. Haematol. 76 (Suppl. 2) (1990) 19–23.

    PubMed  Google Scholar 

  15. Kelsey, M., Weinhardt, B., Collins, P., Newland, A.: Teicoplanin plus ciproflaxacin versus gentamicin plus piperacillin in the treatment of febrile neutropenic patients. Eur. J. Clin. Microbiol. Infect. Dis. 11 (1992) 509–514.

    Article  CAS  PubMed  Google Scholar 

  16. Spencer, R., Winfield, D., Harding, I.: A comparative study of teicoplanin and aztreonam versus piperacillin and gentamicin in haematology patients with clinically diagnosed septicaemia. Int. J. Antimicrob. Agents 1 (Suppl. 1) (1992) 15–20.

    Google Scholar 

  17. Avril, M., Hartmann, O., Valteau-Couanet, D., Brugieres, L., Kalifa, C., Lemerle, J.: Antiinfective prophylaxis with ceftazidime and teicoplanin in children undergoing high-dose chemotherapy and bone marrow transplantation. Pediatr. Hematol. Oncol. 11 (1994) 63–73.

    Article  CAS  PubMed  Google Scholar 

  18. Lee, K., Kang, M., Kim, H., Kang, J., Moon, H., Hong, Y., Kim, D., Park, Y., Kim, S.: The efficacy of teicoplanin (Targocid) for the treatment of infection in cancer patients andin vitro antimicrobial activities. J. Korean Soc Chemother. 11 (1993) 77–83.

    Google Scholar 

  19. Lim, S., Smith, M., Machin, S., Goldstone, A.: Teicoplanin: its role in the empirical therapy of febrile neutropenic episodes. Int. J. Antimicrob. Agents 1 (Suppl. 1) (1992) 25–30.

    Google Scholar 

  20. Webster, A., Russell, S., Souhami, R., Richards, J., Goldstone, A., Gruneberg, R. N.: Use of teicoplanin for Hickman catheter associated infection in immunocompromised patients. J. Hosp. Infect. 10 (1987) 77–82.

    Article  CAS  PubMed  Google Scholar 

  21. Rolston, K., Nguyen, H., Amos, G., Elting, L., Fainstein, V., Bodey, G.: A randomized clinical trial of vancomycin versus teicoplanin for the treatment of gram-positive bacteremia in patients with cancer. J. Infect. Dis. 169 (1994) 350–355.

    CAS  PubMed  Google Scholar 

  22. Chomarat, M., Espinouse, D., Flandrois, J.: Coagulase-negative staphylococci emerging during teicoplanin therapy and problems in the determination of their sensitivity. J. Antimicrob. Chemother. 27 (1991) 475–480.

    Article  CAS  PubMed  Google Scholar 

  23. Kremery, V., Trupl, J., Drgona, L., Lacka, J., Kukuckova, E., Oracova, E.: Nosocomial bacteraemia due to vancomycin-resistantStaphylococcus epidermidis in four patients with cancer, neutropenia, and previous treatment with vancomycin. Eur. J. Infect. Dis. Clin. Microbiol. 15 (1996) 259–261.

    Article  Google Scholar 

  24. Jones, R. N.: Coagulase-negative staphylococci emerging during teicoplanin therapy and the determination of their sensitivity. J. Antimicrob. Chemother. 29 (1992) 725–732.

    Article  CAS  PubMed  Google Scholar 

  25. Campoli-Richards, D. M., Brogden, R., Faulds, D.: Teicoplanin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential. Drugs 40 (1990) 449–486.

    Article  CAS  PubMed  Google Scholar 

  26. Van der Auwera, P., Aoun, M., Meunier, F.: Randomized study of vancomycin versus teicoplanin for the treatment of gram-positive bacterial infections in immunocompromised hosts. Antimicrob. Agents Chemother. 35 (1991) 451–457.

    PubMed  Google Scholar 

  27. Lemerle, S., De Ia Rocque, F., Lamy, R., Fremaux, A., Bernaudin, F., Lobut, J., Reinart, P.: Teicoplanin in combination therapy for febrile episodes in neutropenic and non-neutropenic paediatric patients. J. Antimicrob. Chemother. 21 (Suppl. A) (1988) 113–116.

    PubMed  Google Scholar 

  28. Lui, C.-Y., Lee, W.-S., Fung, C.-P., Cheng, N.-C., Liu, C.-L., Yang, S.-P., Chen, S.-L.: Comparative study of teicoplanin vs. vancomycin for the treatment of methicillin-resistantStaphylococcus aureus bacteraemia. Clin. Drug Invest. 12 (1996) 80–87.

    Google Scholar 

  29. Wood, M. J.: The comparative efficacy and safety of teicoplanin and vancomycin. J. Antimicrob. Chemother. 37 (1996) 209–222.

    Article  Google Scholar 

  30. Schaison, G., Decroly, F.: Prophylaxis, cost and effectiveness of therapy of infections caused by gram-positive organisms in neutropenic children. J. Antimicrob. Chemother 27 (Suppl. B) (1991) 61–67.

    PubMed  Google Scholar 

  31. Preis, S., Jurgens, H., Friedland, C., Oudekotte-David, A., Thomas, L.: Ceftriaxone alone or in combination with teicoplanin in the management of febrile episodes in neutropenic children and adolescents with cancer on an outpatient base. Klin. Pediatr. 205 (1993) 295–299.

    Article  CAS  Google Scholar 

  32. Wilson, A., Gruneberg, R.: Use of teicoplanin in community medicine. Eur. J. Clin. Microbiol. Infect. Dis. 13 (1994) 701–710.

    Article  CAS  PubMed  Google Scholar 

  33. Harding, I., Garaud, J.: Teicoplanin in the treatment of infections caused by coagulase-negative staphylococci. J. Antimicrob. Chemother. 21 (Suppl. A) (1988) 93–103.

    PubMed  Google Scholar 

  34. Smith, S., Cheesbrough, J., Makris, M., Davies, J.: Teicoplanin administration in patients experiencing reactions to vancomycin. J. Antimicrob. Chemother. 23 (1989) 810–812.

    Article  CAS  PubMed  Google Scholar 

  35. De Vries, E., Van Weel-Sipman, M., Vossen, J.: A four-year-old child with teicoplanin allergy but no evidence of cross-reaction with vancomycin. Paediatr. Infect. Dis. J. 13 (1994) 167.

    Article  Google Scholar 

  36. Uttley, A., George, R., Naidoo, J., Woodford, N., Johnson, A., Collins, C., Morrison, D., Gilfillan, A., Fitch, L., Heptonstall, J.: High level vancomycin resistant enterococci causing hospital infections. Epidemiol. Infect. 103 (1989) 173–181.

    Article  CAS  PubMed  Google Scholar 

  37. Manso, E., De Sio, G., Biavesco, F., Varaldo, P., Sambo, G., Maffei, C.: Vancomycin-resistant enterococci. Lancet 342 (1993) 616–617.

    CAS  PubMed  Google Scholar 

  38. Rowe, P. M.: Preparing for battle against vancomycin resistance. Lancet 347 (1996) 252.

    Article  Google Scholar 

  39. Hughes, W., Armstrong, D., Bodey, G., Brown, A., Edwards, J., Feld, R., Pizzo, P., Rolston, K., Young, L.: Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. Clin. Inf. Dis. 25 (1997) 551–573.

    Article  CAS  Google Scholar 

  40. Ford, D., Reilly, W., Wood, J., Classen, D., Burke, J.: Oral antimicrobial prophylaxis in bone marrow transplant recipients. A randomised trial of ciprofloxacin versus ciprofloxacin and vancomycin. Antimicrob. Agents Chemother 42 (1998) 1402–1405.

    CAS  PubMed  Google Scholar 

  41. Verhagen, C., De Pauw, B.: Teicoplanin for therapy of gram-positive infections in neutropenic patients. Int. J. Clin. Pharm. Res. 7 (1987) 491–498.

    CAS  Google Scholar 

  42. Menichetti, F., Del Favero, A., Bucaneve, G., Aversa, F., Baldelli, R., Felicini, R., Terrenzi, A., Pauluzzi, S.: Teicoplanin in empirical combined antibiotic therapy of bacteraemia in bone marrow transplant patients. J. Antimicrob. Chemother. 21 (Suppl. A) (1988) 105–111.

    PubMed  Google Scholar 

  43. Schaison, G., Decroly, F.: Prophylaxis, cost and efféctiveness of therapy caused by gram-positive organisms in neutropenic children. J. Antimicrob. Chemother. 27 (Suppl. B) (1991) 61–67.

    PubMed  Google Scholar 

  44. Guaglianone, M., Bachini, V., Mosconi, G., Dragonetti, C.: Teicoplanin for empiric combined antibiotic therapy in febrile granulocytopenic patients. Multicenter open trial. 8th Mediterranean Congress of Chemotherapy, Athens, 1992, 374–375 (abstr. 498).

  45. Fanci, R., Leoni, F., Bosi, A.: Teicoplanin: resultati preliminari nel trattamento di episodi febbrili resistenti all' associazione ceftazidime +amikacina in pasienti leucemici. In: Proceedings of the 16th National Congress of the Italian Society of Chemotherapy, Florence, March 1989, 34–37.

  46. Ricci, P., Calori, E., Verlicchi, F., Tosi, P., Albertazzi, L., Varioli, O., Nanetti, A., Tura, S.: La Teicoplania nella terapia antibiotica empirica degli episodi febbrili in paseienti con malatie ematologiche neoplastiche. Farmaci Terapia 6 (1989) 36–39.

    Google Scholar 

  47. Espinouse, D., Chomarat, M.: Utilisation de Ia teicoplanine chez les patients neutropéniques: intérêts et limites. Pathol. Biol. 38 (1990) 552–556.

    CAS  PubMed  Google Scholar 

  48. Klaasen, U., Nowroustan, M., Werk, S., Retter, W., Mengelkoch, B., Eberhardt, W., Muller, M., Seeber, S.: Sequential antimicrobial therapy for the treatment of infections in neutropenic patients with haematologic malignancies. In: Program and Abstracts, 4th Biennial Conference on Chemotherapy of Infectious Diseases and Malignancies, Prague, 1992 (abstr. 294).

  49. Fauser, A., Lang, E., D'Iken, G., Bross, K., Schmid, J., Sorgel, F.: Treatment of severe sepsis in bone marrow transplant recipients with teicoplanin in combination with β-lactams and aminoglycosides. Infection 9 (1991) 195–200.

    Article  Google Scholar 

  50. Kinsey, S., Machin, S., Goldstone, A.: Ceftazidime monotherapy is as effective as ceftazidime combined with gentamicin in the treatment of febrile neutropenic patients. J. Hosp. Infect. 15 (Suppl. A) (1990) 49–53.

    Article  PubMed  Google Scholar 

  51. Ketley, N., Kelsey, S., Newland, A.: Teicoplanin and ciprofloxacin as outpatient treatment of Hickman catheter infections. Br. J. Haematol. 84 (Suppl. 1) (1993) 32.

    Google Scholar 

  52. Smith, C. L., Milliken, S., Powles, R., Da Costa, F., Gore, M., Benjamin, S., Talbot, D., Ellis, L., Large, J., Jameson, B.: Teicoplanin compared to flucloxacillin for antibiotic treatment of neutropenic patients. Br. J. Haematol. 76 (Suppl. 2) (1990) 6–9.

    Article  PubMed  Google Scholar 

  53. Aoun, M., Van der Auwera, P., Varthalitis, I., Bourguignon, A., Janssen, M., Daneau, D., Meunier, F.: A prospective randomized study of pefloxacin versus teicoplanin in the treatment of gram-positive coccal infections in cancer patients: early termination due to emergence of resistance to fluoroquinolones. Support Care Cancer 2 (1994) 191–196.

    Article  CAS  PubMed  Google Scholar 

  54. Studena, M., Hlavacova, E., Hel'Pianski, L., Vonkomerova, A., Lacka, J., Studena, V., Kuckuckova, E., Kollar, T., Pichna, P., Salak, T.: A comparison of teicoplanin/netilmicin and teicoplanin/pefloxacin in the management of febrile neutropenia. Chemotherapy 40 (1994) 431–434.

    Article  CAS  PubMed  Google Scholar 

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  1. Dept. of Clinical and Laboratory Haematology, Queens Medical Centre, University Hospital, NG7 2UH, Nottingham, UK

    J. M. Davies M.A., M.D., F.R. C.P., F.R.C. Path

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Davies, J.M. A survey of the use of teicoplanin in patients with haematological malignancies and solid tumours. Infection 26, 389–395 (1998). https://doi.org/10.1007/BF02770842

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