The efficacy of
teicoplanin, a
glycopeptide antibiotic, in
endocarditis is controversial, with differences observed in the efficacies of the regimens used in clinical trials in the USA and Europe. This retrospective study examined the outcomes, efficacy and safety of mono- and combination
antibiotic therapy using
teicoplanin, particularly in cases of Staphylococcus aureus
endocarditis. A total of 115 patients, typically mixed
endocarditis patients intolerant of previous
antibiotic treatment, was enrolled at 29 centres throughout Europe. Combination
therapy was more successful than monotherapy for treating native valve
endocarditis (NVE) (93 vs. 85%, p > 0.05, NS) and for treating S. aureus NVE (84 vs. 50%, p > 0.05). Efficacies for prosthetic valve
endocarditis (PVE) were similar (75 vs. 79%), while combination
therapy was more successful in S. aureus PVE (100 vs. 67%) though the number of such patients was small (NS). Adverse events were reported by 24% of patients, with 19% probably or possibly related to
teicoplanin. In 9% of cases the adverse event led to the termination of
therapy.
Teicoplanin was judged to be efficacious in mono- or combination
therapy in streptococcal
endocarditis, though augmentation with an
aminoglycoside is recommended. The efficacy of
teicoplanin demonstrated in enterococcal
endocarditis represents a major therapeutic advance.