A RANDOMIZED DOUBLE-BLIND TRIAL OF VANCOMYCIN VERSUS TEICOPLANIN FOR THE TREATMENT OF GRAM-POSITIVE BACTEREMIA IN PATIENTS WITH CANCER

In a prospective, randomized, double-blind study comparing teicoplanin and vancomycin for the treatment of gram-positive bacteremias in neutropenic patients, teicoplanin was given at 6 mg/kg of body weight every 24 h intravenously (iv) after initial loading every 12 h for three doses, while vancomycin was administered at 15 mg/kg every 12 h iv. At enrollment, both groups were comparable in age, sex, underlying hematologic or neoplastic disorder, baseline renal functions, and incidence of neutropenia. Treatment was successful in 19 (90%) of 21 patients who received teicoplanin and 24 (96%) of 25 who received vancomycin (P=.58). Adverse reactions occurred more often in the vancomycin group (31%) than in the teicoplanin group (9%; P=.06) and were primarily cutaneous or gastrointestinal. In conclusion, teicoplanin was better tolerated than vancomycin, and no statistically significant difference in efficacy was detected with the sample size in this study.