Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10549-10556
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10549
Teicoplanin combined with conventional vancomycin therapy for the treatment of pulmonary methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis infections
Wei Wu, Min Liu, Jia-Jing Geng, Mei Wang
Wei Wu, Jia-Jing Geng, Mei Wang, Laboratory Medicine, Bejing Tongren Hospital, Capital Medical University, Beijing 100176, China
Min Liu, Department of General Practice, The Community Health Services Center in Lumen, Beijing 100080, China
Author contributions: Wu W and Wang M designed the research study; Liu M performed the research; Geng JJ analyzed the data and wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the Beijing Tongren Hospital, Capital Medical University Institutional Review Board (Approval No. TRECKY2020-100).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei Wang, MHSc, Attending Doctor, Laboratory Medicine, Bejing Tongren Hosptial, Capital Medical University, No. 2 West Ring South Road, Beijing 100176, China. wmeimeiw@163.com
Received: July 28, 2021
Peer-review started: July 28, 2021
First decision: August 19, 2021
Revised: August 24, 2021
Accepted: October 14, 2021
Article in press: October 14, 2021
Published online: December 6, 2021
Abstract
BACKGROUND

Vancomycin and teicoplanin are both antibiotics that have significant antimicrobial effects on Gram-positive cocci.

AIM

To explore the value of teicoplanin combined with conventional (vancomycin only) anti-infective therapy for the treatment of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis pulmonary infections.

METHODS

A total of 86 patients with methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis pulmonary infections, treated in our hospital between January 2018 and February 2020, were assigned to the study and control groups using a random number table method, with 43 patients in each group. The control group received conventional treatment (vancomycin), and the study group received both teicoplanin and conventional treatment. The following indicators were assessed in both groups: the time required for symptom relief, treatment effectiveness, serum levels of inflammatory factors (procalcitonin, interleukin-1β, tumor necrosis factor-α, C-reactive protein), clinical pulmonary infection scores before and after treatment, and the incidence of adverse reactions.

RESULTS

Patients in the study group were observed to have faster cough and expectoration resolution, white blood cell count normalization, body temperature normalization, and rales disappearance than patients in the control group (all P < 0.05); the total rate of effectiveness was 93.02% in the study group, higher than the 76.74% in the control group (P < 0.05). The pre-treatment serum levels of procalcitonin, interleukin-1β, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were similar among the patients in both groups. However, the post-treatment serum levels of procalcitonin, interleukin-1β, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were significantly lower in the study group than in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the groups.

CONCLUSION

Compared with conventional (vancomycin only) therapy, teicoplanin and vancomycin combination therapy for patients with pulmonary methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis infections can improve patient clinical symptoms, modulate serum inflammatory factor levels, and improve treatment efficacy, without increasing the risk of adverse reactions.

Keywords: Vancomycin, Teicoplanin, Methicillin-resistant Staphylococcus aureus, Methicillin-resistant Staphylococcus epidermidis, Lung infection

Core Tip: Vancomycin and teicoplanin are both essential drugs in the clinical treatment of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis lung infections and have significant antimicrobial effects on Gram-positive cocci. Here, we discuss the efficacy and safety of these two key antibiotics.