Department of Pulmonology and Critical Care Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
BMC Infect Dis. 2022 Jul 7;22(1):600. doi: 10.1186/s12879-022-07549-2.
Very few studies have compared the effects and side effects of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia. This study aimed to compare the efficacy and safety of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia.
This study examined 116 patients with methicillin-resistant Staphylococcus aureus pneumonia who met the inclusion criteria and were treated with either vancomycin (n = 54) or teicoplanin (n = 62). The primary (i.e., clinical failure during treatment) and secondary outcomes (i.e., mortality rates, discontinuation of study drugs due to treatment failure, side effects, and clinical cure) were evaluated.
The vancomycin group presented lower clinical failure rates (25.9% vs. 61.3%, p < 0.001), discontinuation due to treatment failure (22.2% vs. 41.9%, p = 0.024), and mortality rates (3.7% vs 19.4%, p = 0.010). The Cox proportional hazard model revealed that teicoplanin was a significant clinical failure predictor compared with vancomycin (adjusted odds ratio, 2.198; 95% confidence interval 1.163-4.154). The rates of drug change due to side effects were higher in the vancomycin group than in the teicoplanin group (24.1% vs. 1.6%, p < 0.001).
Vancomycin presented favorable treatment outcomes and more side effects compared with teicoplanin, which suggests that clinicians would need to consider the efficacy and potential side effects of these drugs before prescription.
很少有研究比较万古霉素和替考拉宁治疗耐甲氧西林金黄色葡萄球菌肺炎的效果和副作用。本研究旨在比较万古霉素和替考拉宁治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效和安全性。
本研究纳入了符合纳入标准的 116 例耐甲氧西林金黄色葡萄球菌肺炎患者，分别接受万古霉素（n=54）或替考拉宁（n=62）治疗。评估了主要（即治疗期间临床失败）和次要结局（即死亡率、因治疗失败而停止研究药物、副作用和临床治愈）。
万古霉素组的临床失败率（25.9%比 61.3%，p<0.001）、因治疗失败而停药的发生率（22.2%比 41.9%，p=0.024）和死亡率（3.7%比 19.4%，p=0.010）均较低。Cox 比例风险模型显示，与万古霉素相比，替考拉宁是临床失败的显著预测因素（调整优势比，2.198；95%置信区间，1.163-4.154）。因副作用而换药的发生率在万古霉素组高于替考拉宁组（24.1%比 1.6%，p<0.001）。
与替考拉宁相比，万古霉素具有更好的治疗效果和更多的副作用，这表明临床医生在开处方前需要考虑这些药物的疗效和潜在副作用。
