Bolus or infusion teicoplanin for intravascular catheter associated infections in immunocompromised patients?

An unexpected low efficacy of teicoplanin in the treatment of coagulase negative staphylococcal (CNS) infections on a regional Bone Marrow Transplant (BMT) Unit led to a retrospective study. CNS infections treated with gylcopeptides in BMT patients with in-dwelling central venous lines between May 1990 and May 1995 were reviewed. Efficacy rates of 50% for teicoplanin compared with 80% for vancomycin despite comparable antibiotic susceptibility. Glycopeptides have bactericidal action which is time dependent. Teicoplanin was administered by bolus injection during the study period and it is suggested that this observed difference in efficacy is caused by the short duration of exposure of luminal bacteria.