Van Laethem Y, Hermans P, De Wit S, Goosens H, Clumeck N
Division of Infectious Diseases, Saint-Pierre University Hospital, Brussels, Belgium.
J Antimicrob Chemother. 1988 Jan;21 Suppl A:81-7. doi: 10.1093/jac/21.suppl_a.81.
Twenty-one patients were included in an open randomized study comparing vancomycin 1 g bd with teicoplanin 400 mg daily in severe methicillin-resistant Staphylococcus aureus infections. The median duration of therapy was 15 days for vancomycin and 21 days for teicoplanin. Most patients presented with severe underlying conditions, such as major surgery (8), solid tumours (5), multiple trauma (3). The infections treated, included septicaemia, osteomyelitis, bronchopneumonia, cellulitis and acute pyelonephritis. Mean MICs of the strains were 0.39 mg/l for vancomycin and 0.195 mg/l for teicoplanin. Mean trough and peak serum concentrations of vancomycin were 14.3 +/- 5 mg/l and 34.3 +/- 13 mg/l, while the teicoplanin values were 7.5 +/- 4 mg/l and 17 +/- 7 mg/l. The cure rate was seven of 12 in the teicoplanin group and six of nine in the vancomycin group, with four and three cases, respectively, of improvement and one failure in the teicoplanin group. Transient renal impairment occurred in two cases with both regimens; superinfection and colonization in three patients and one patient, respectively, with both regimens.
21例患者纳入一项开放性随机研究，该研究比较了在严重耐甲氧西林金黄色葡萄球菌感染中，每日两次静脉滴注1g万古霉素与每日静脉滴注400mg替考拉宁的疗效。万古霉素治疗的中位疗程为15天，替考拉宁为21天。大多数患者伴有严重的基础疾病，如大手术（8例）、实体瘤（5例）、多发伤（3例）。治疗的感染包括败血症、骨髓炎、支气管肺炎、蜂窝织炎和急性肾盂肾炎。菌株的平均最低抑菌浓度（MIC），万古霉素为0.39mg/L，替考拉宁为0.195mg/L。万古霉素的平均谷浓度和峰浓度分别为14.3±5mg/L和34.3±13mg/L，而替考拉宁的值分别为7.5±4mg/L和17±7mg/L。替考拉宁组12例中有7例治愈，万古霉素组9例中有6例治愈，替考拉宁组分别有4例和3例病情改善，1例治疗失败。两种治疗方案均有2例出现短暂性肾功能损害；两种治疗方案分别有3例和1例发生二重感染和定植。
