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Original Articles
Efficacies of Teicoplanin in Patients with Febrile Neutropenia
Dong-Gun Lee, M.D., Dong-Seok Yim, M.D.*, Su-Mi Choi, M.D., Sun Hee Park, M.D., Jin-Hong Yoo, M.D., Jung-Hyun Choi, M.D., Woo-Sung Min, M.D., Wan-Shik Shin, M.D. and Chun-Choo Kim, M.D.
Department of Internal Medicine, Department of Pharmacology*, The Catholic University of Korea, Seoul, Korea
Vol.36 Num.2 (p83~91)
Background:This study was done to elucidate the efficacy of teicoplanin as the empirical treatment for febrile neutropenia.
Methods:Patients were randomized to two groups according to pharmaceutical company (company A or B). Total of 49 patients (A, 27; B, 22) with neutropenic fever were studied prospectively for 6 months (Jul. 2003-Dec. 2003). Patients received 400 mg i.v. once, then 200 mg i.v. once daily.
Results:Groups were matched for all demographic variables. Most of the patients were concurrently receiving nephrotoxic drugs. Gram positive microorganisms were isolated in 8 patients for A and 7 patients for B. Resistance rate against teicoplanin was 22.2% in A and 28.6% in B (P=1.0; 0.61 < 95% confidence interval [CI] < 1.95). Among the patients with microbiologically documented infection, clinical cure or improvement was seen in 4 (50%) of 8 patients for A and 4 (57.1%) of 7 patients for B (P=1.00; 0.29 <95%CI <2.60). Bacteriologic efficacy was assessed as follows; elimination in 5 (55.6%), elimination with relapse in 2 (22.2%), resistance in 2 (22.2%) out of 9 gram-positive bacteria for A and 5 (51.4%), 0 (0.0%), 2 (28.6%) out of 7 bacteria for B, respectively (P=0.28). There were no significant differences in duration of fever, duration of use of teicoplanin, and overall mortality. The incidence of nephrotoxicity and ototoxicity was not significant.
Conclusion:For using teicoplanin as the empirical therapy for febrile neutropenia, the rate of clinical, microbiological response, and nephrotoxicity was 53.3%, 62.5%, and 16.3% respectively with no significant differences between the 2 preparations of teicoplanin. Supplementary evaluation on the adequate dose and duration of teicoplanin may be required.
Keywords : Neutropenia, Teicoplanin, Treatment outcome