Teicoplanin is a glycopeptide antibiotic used to treat serious infections caused by gram-positive bacteria. It is used mainly to treat organisms to which first-line antibiotics do not respond or in patients who cannot tolerate them. This drug has a spectrum of action that is similar to that of vancomycin, another injectable glycopeptide drug. Teicoplanin might not be available in some countries.
Bacteria are microorganisms that infect the body and multiply rapidly. Despite their tiny structure, bacteria are complicated and varied structures. Simply classified, bacteria can be divided into gram-positive and gram-negative organisms by the structure of the cell wall, including the amount of peptidoglycans in their cell walls. Different antibiotics work at different stages of bacterial growth to eradicate the organism.
Cell wall synthesis is where teicoplanin acts. It inhibits gram-positive bacterial cell wall synthesis. It is active against a number of organisms, among them Staphylococcus aureus, including methicillin-resistant organisms, Listeria monocytogenes and Clostridium difficile. Methicillin-resistant Staphylococcus aureus (MRSA) is an organism that can be extremely difficultd to treat because of its resistance to standard therapy. Clostridium difficile causes severe diarrhea.
Teicoplanin can be used to treat infections of the bone, skin, heart, respiratory tract, urinary tract and gastrointestinal tract. The dose of teicoplanin used depends on the site and organism involved in the infection. It sually is given as a daily dose, either intravenously or intramuscularly, and the duration of treatment depends on the infection. For some infections, such as osteomyolitis or an infection of the bone, treatment might be needed for three weeks or longer.
The use of teicoplanin is normally limited to in-hospital patients, at least initially, because it is used only in severe infections that do not respond to first-line drugs and is primarily used as an injectable. It is also sometimes used to treat infections in patients who cannot take other antibiotics, such as those who have a penicillin and cephalosporin allergy. A clinical response is usually seen within 48-72 hours.
As with any medication, teicoplanin can have adverse drug effects, including hypersensitivity or allergy. The patient typically will be closely monitored to establish and respond to any possible side effects that might occur. The attending doctor will also take into account any concomitant diseases or medications before instituting teicoplanin therapy, because interactions might occur. Patients who have kidney disease might need a lower dose.
