Glycopeptides in the treatment of staphylococcal infections.

Gram-positive bacteria are rapidly becoming the most important pathogens in nosocomial infections. In recent years, attention and concern have been focused on the gram-positive bacteria, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis. These microorganisms are well equipped to exert their pathogenic effects and to display virulence. Treatment of severe infections caused by gram-positive bacteria remains difficult because of the increase in infections caused by methicillin-resistant staphylococci, and this has renewed interest in the glycopeptide antibiotics, vancomycin and teicoplanin. According to National Nosocomial Infection Surveillance Study data, in 1989, 60% of coagulase-negative staphylococci and 22% of Staphylococcus aureus strains showed methicillin resistance. Among other factors, successful antimicrobial therapy depends on rapid and reliable antibiotic delivery to the infection site at a concentration adequate to inhibit the majority of infecting organisms. Glycopeptides may be important in the therapy of catheter-related infections, which are mainly caused by coagulase-negative staphylococci and Staphylococcus aureus.