Therapeutic Uses

Teicoplanin has been used to treat a wide variety of infections, including osteomyelitis and endocarditis, caused by methicillin-resistant and methicillin-susceptible staphylococci, streptococci, and enterococci. Teicoplanin generally is comparable to vancomycin in efficacy, except for treatment failures from low doses used for such serious infections as endocarditis. Teicoplanin is not as efficacious as antistaphylococcal penicillins for treating bacteremia and endocarditis caused by methicillin-susceptible S. aureus (cure rates of 60—70% vs. 85—90% for the penicillins). The efficacy of teicoplanin against S. aureus may be improved by adding an aminoglycoside (e.g., gentamicin) to provide a synergistic effect. Strains of streptococci are uniformly susceptible to teicoplanin. This drug has been very effective in a once-daily regimen for patients with strepto-coccal osteomyelitis or endocarditis. Teicoplanin is among the most active drugs against entero-cocci and apparently is effective, although only bacteriostatic, for serious enterococcal infections. It should be combined with gentamicin to achieve a bactericidal effect in the treatment of entero-coccal endocarditis.

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