Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis

J.L. del Pozo (1, 2) , M. García Cenoz (3) , S. Hernáez (2) , A. Martínez (4) , A. Serrera (2) , A. Aguinaga (2) , M. Alonso (2) , J. Leiva (2)

1 Division of Infectious Diseases
2 Department of Clinical Microbiology
3 Public Health Institute of Navarre
4 Department of Radiology

The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (=0.06). In the Cox regression analysis, fever beyond 48h of treatment was a significant predictor of treatment failure (=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after the beginning antimicrobial lock therapy was associated with treatment failure.

Mots clés: Catheter-related infection; Bacteraemia; Teicoplanin; Biofilms

J.L. del Pozo, M. García Cenoz, S. Hernáez, A. Martínez, A. Serrera, et al.. Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis. International Journal of Antimicrobial Agents, 2009, 34 (5), pp.482. ⟨10.1016/j.ijantimicag.2009.06.020⟩. ⟨hal-00556352⟩