Teicoplanin as an anti-methicillin resistant staphylococcus aureus agent in infections of severely poisoned intensive care unit patients/Tehran- Iran

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is related to high morbidity and mortality. Teicoplanin is a semi synthetic glycopeptide antibiotic with a spectrum of activity similar to vancomycin. Our objective is the evaluation of efficacy and safety of Teicoplanin in MRSA infections among severely poisoned intensive care unit (ICU) patients.Methods: During a 6 months period, in a prospective cross sectional study, 54 eligible patients were recruited from among 80 who were clinically suspicious for MRSA infections. The efficacy and safety ofTeicoplanin by loding dose of 6 mg/kg (maximum 400 mg per dose) for three loading doses 12 hours apart and then every 24 hours was evaluated 5 times.The clinical findings, laboratory data, and bacteriologic responses were categorized as cure, improvement and failure. Results: The mean(SD) age was 36.3(13.3) years. 75.9 were male. Suicidal attempts were recorded in 63. The most common poisoning was TCAs, BZDs, tramadol and opium. 94.4 were unconscious and under mechanical ventilation. Tracheal cultures were positive in 98.1 by VAP diagnosis. ICU length of stay was between 4-54 days. Total clinical effectiveness was 90.4, and failure 9.6. Mortality rate was 9/54 (16.6 ). On the fourth visit, the adverse effects included: rash (11.10), anemia (36.17), nephrotoxicity (17.02) and thrombocytopenia < 150000 (100). Other side effects such as: leucopenia, severe thrombocytopenia (< 50000), pancytopenia and red man syndrome were not detected.Conclusions: Teicoplanin can be suggested for use in forMRSA infections among severely poisoned patient, based on its efficacy, safety, half life and tolerance. © Mattioli 1885