Use of a glycopeptide antibiotic, teicoplanin, in the treatment of septicaemia caused by gram-positive bacteria.

Teicoplanin, a recently introduced glycopeptide antibiotic, has been used, in combination with other antibiotics, to treat 31 episodes of septicaemia caused by Gram-positive organisms. Teicoplanin has double the activity of vancomycin against many Gram-positive bacteria, but allergic reactions and toxicity appear to be infrequent. A single daily dose is sufficient to maintain therapeutic levels, which is an advantage in conditions requiring long-term treatment. Of the 31 episodes treated, 16 were associated with infective endocarditis, 11 with Hickman catheter infection, two with bone and joint infection, and two with infection of other indwelling prosthetic devices. Staphylococcus epidermidis was isolated in 18 infections, of which seven treatment courses were unsuccessful. One death occurred from an uncontrolled infection, three deaths from underlying disease (one of which had relapsed twice), and one after withdrawal of treatment following febrile reaction. Eleven episodes were cured. Six episodes of Staphylococcus aureus septicaemia were treated, of which two failed to respond, two relapsed, one improved and one was cured. The remaining seven episodes were caused by streptococci (including Streptococcus faecalis), and in all of them cure was achieved despite the lack of consistent serum bactericidal activity in vitro.