Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection
ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Rando...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Diogo Diniz Gomes Bugano [verfasserIn] Alexandre Biasi Cavalcanti [verfasserIn] Anderson Roman Goncalves [verfasserIn] Claudia Salvini de Almeida [verfasserIn] Eliézer Silva [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch ; Portugiesisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
Anti-bacterial agents/adverse effects |
|---|
| Übergeordnetes Werk: |
In: Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017, 9(2011), 3, Seite 265-282 |
|---|---|
| Übergeordnetes Werk: |
volume:9 ; year:2011 ; number:3 ; pages:265-282 |
| Links: |
Link aufrufen |
|---|
| DOI / URN: |
10.1590/s1679-45082011ao2020 |
|---|
| Katalog-ID: |
DOAJ013923722 |
|---|
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| 520 | |a ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. | ||
| 650 | 4 | |a Anti-bacterial agents/adverse effects | |
| 650 | 4 | |a Anti-bacterial agents/therapeutic use | |
| 650 | 4 | |a Teicoplanin/adverse effects | |
| 650 | 4 | |a Teicoplanin/therapeutic use | |
| 650 | 4 | |a Vancomycin/adverse effects | |
| 650 | 4 | |a Vancomycin/therapeutic use | |
| 650 | 4 | |a Kidney/drug effects | |
| 650 | 4 | |a Drug eruptions/etiology | |
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| 700 | 0 | |a Anderson Roman Goncalves |e verfasserin |4 aut | |
| 700 | 0 | |a Claudia Salvini de Almeida |e verfasserin |4 aut | |
| 700 | 0 | |a Eliézer Silva |e verfasserin |4 aut | |
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10.1590/s1679-45082011ao2020 doi (DE-627)DOAJ013923722 (DE-599)DOAJd3d74658b539460e9e1ba1af593e9ce7 DE-627 ger DE-627 rakwb eng por Diogo Diniz Gomes Bugano verfasserin aut Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. Anti-bacterial agents/adverse effects Anti-bacterial agents/therapeutic use Teicoplanin/adverse effects Teicoplanin/therapeutic use Vancomycin/adverse effects Vancomycin/therapeutic use Kidney/drug effects Drug eruptions/etiology Medicine R Alexandre Biasi Cavalcanti verfasserin aut Anderson Roman Goncalves verfasserin aut Claudia Salvini de Almeida verfasserin aut Eliézer Silva verfasserin aut In Einstein (São Paulo) Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017 9(2011), 3, Seite 265-282 (DE-627)561316503 (DE-600)2418293-X 23176385 nnns volume:9 year:2011 number:3 pages:265-282 https://doi.org/10.1590/s1679-45082011ao2020 kostenfrei https://doaj.org/article/d3d74658b539460e9e1ba1af593e9ce7 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=pt kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=en kostenfrei https://doaj.org/toc/2317-6385 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 9 2011 3 265-282 |
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10.1590/s1679-45082011ao2020 doi (DE-627)DOAJ013923722 (DE-599)DOAJd3d74658b539460e9e1ba1af593e9ce7 DE-627 ger DE-627 rakwb eng por Diogo Diniz Gomes Bugano verfasserin aut Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. Anti-bacterial agents/adverse effects Anti-bacterial agents/therapeutic use Teicoplanin/adverse effects Teicoplanin/therapeutic use Vancomycin/adverse effects Vancomycin/therapeutic use Kidney/drug effects Drug eruptions/etiology Medicine R Alexandre Biasi Cavalcanti verfasserin aut Anderson Roman Goncalves verfasserin aut Claudia Salvini de Almeida verfasserin aut Eliézer Silva verfasserin aut In Einstein (São Paulo) Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017 9(2011), 3, Seite 265-282 (DE-627)561316503 (DE-600)2418293-X 23176385 nnns volume:9 year:2011 number:3 pages:265-282 https://doi.org/10.1590/s1679-45082011ao2020 kostenfrei https://doaj.org/article/d3d74658b539460e9e1ba1af593e9ce7 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=pt kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=en kostenfrei https://doaj.org/toc/2317-6385 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 9 2011 3 265-282 |
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10.1590/s1679-45082011ao2020 doi (DE-627)DOAJ013923722 (DE-599)DOAJd3d74658b539460e9e1ba1af593e9ce7 DE-627 ger DE-627 rakwb eng por Diogo Diniz Gomes Bugano verfasserin aut Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. Anti-bacterial agents/adverse effects Anti-bacterial agents/therapeutic use Teicoplanin/adverse effects Teicoplanin/therapeutic use Vancomycin/adverse effects Vancomycin/therapeutic use Kidney/drug effects Drug eruptions/etiology Medicine R Alexandre Biasi Cavalcanti verfasserin aut Anderson Roman Goncalves verfasserin aut Claudia Salvini de Almeida verfasserin aut Eliézer Silva verfasserin aut In Einstein (São Paulo) Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017 9(2011), 3, Seite 265-282 (DE-627)561316503 (DE-600)2418293-X 23176385 nnns volume:9 year:2011 number:3 pages:265-282 https://doi.org/10.1590/s1679-45082011ao2020 kostenfrei https://doaj.org/article/d3d74658b539460e9e1ba1af593e9ce7 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=pt kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=en kostenfrei https://doaj.org/toc/2317-6385 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 9 2011 3 265-282 |
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10.1590/s1679-45082011ao2020 doi (DE-627)DOAJ013923722 (DE-599)DOAJd3d74658b539460e9e1ba1af593e9ce7 DE-627 ger DE-627 rakwb eng por Diogo Diniz Gomes Bugano verfasserin aut Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. Anti-bacterial agents/adverse effects Anti-bacterial agents/therapeutic use Teicoplanin/adverse effects Teicoplanin/therapeutic use Vancomycin/adverse effects Vancomycin/therapeutic use Kidney/drug effects Drug eruptions/etiology Medicine R Alexandre Biasi Cavalcanti verfasserin aut Anderson Roman Goncalves verfasserin aut Claudia Salvini de Almeida verfasserin aut Eliézer Silva verfasserin aut In Einstein (São Paulo) Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017 9(2011), 3, Seite 265-282 (DE-627)561316503 (DE-600)2418293-X 23176385 nnns volume:9 year:2011 number:3 pages:265-282 https://doi.org/10.1590/s1679-45082011ao2020 kostenfrei https://doaj.org/article/d3d74658b539460e9e1ba1af593e9ce7 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=pt kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=en kostenfrei https://doaj.org/toc/2317-6385 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 9 2011 3 265-282 |
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10.1590/s1679-45082011ao2020 doi (DE-627)DOAJ013923722 (DE-599)DOAJd3d74658b539460e9e1ba1af593e9ce7 DE-627 ger DE-627 rakwb eng por Diogo Diniz Gomes Bugano verfasserin aut Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. Anti-bacterial agents/adverse effects Anti-bacterial agents/therapeutic use Teicoplanin/adverse effects Teicoplanin/therapeutic use Vancomycin/adverse effects Vancomycin/therapeutic use Kidney/drug effects Drug eruptions/etiology Medicine R Alexandre Biasi Cavalcanti verfasserin aut Anderson Roman Goncalves verfasserin aut Claudia Salvini de Almeida verfasserin aut Eliézer Silva verfasserin aut In Einstein (São Paulo) Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2017 9(2011), 3, Seite 265-282 (DE-627)561316503 (DE-600)2418293-X 23176385 nnns volume:9 year:2011 number:3 pages:265-282 https://doi.org/10.1590/s1679-45082011ao2020 kostenfrei https://doaj.org/article/d3d74658b539460e9e1ba1af593e9ce7 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=pt kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082011000300265&tlng=en kostenfrei https://doaj.org/toc/2317-6385 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 9 2011 3 265-282 |
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Diogo Diniz Gomes Bugano |
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Cochrane meta-analysis: teicoplanin versus vancomycin for proven or suspected infection |
| abstract |
ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. |
| abstractGer |
ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. |
| abstract_unstemmed |
ABSTRACT Objective: To compare efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. It may be reasonable to consider teicoplanin for patients at higher risk for acute kidney injury. |
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Methods: Data Sources: Cochrane Renal Group's Specialized Register, CENTRAL, MEDLINE, EMBASE, nephrology textbooks and review articles. Inclusion criteria: Randomized controlled trials in any language comparing teicoplanin to vancomycin for patients with proven or suspected infection. Data extraction: Two authors independently evaluated methodological quality and extracted data. Study investigators were contacted for unpublished information. A random effect model was used to estimate the pooled risk ratio (RR) with 95% confidence interval (CI). Results: A total of 24 studies (2,610 patients) were included. The drugs had similar rates of clinical cure (RR: 1.03; 95%CI: 0.98-1.08), microbiological cure (RR: 0.98; 95%CI: 0.93-1.03) and mortality (RR: 1.02; 95%CI: 0.79-1.30). Teicoplanin had lower rates of skin rash (RR: 0.57; 95%CI: 0.35-0.92), red man syndrome (RR: 0.21; 95%CI: 0.08-0.59) and total adverse events (RR: 0.73; 95%CI: 0.53-1.00). Teicoplanin reduced the risk of nephrotoxicity (RR: 0.66; 95%CI: 0.48-0.90). This effect was consistent for patients receiving aminoglycosides (RR: 0.51; 95%CI: 0.30-0.88) or having vancomycin doses corrected by serum levels (RR: 0.22; 95%CI: 0.10-0.52). There were no cases of acute kidney injury needing dialysis. Limitations: Studies lacked a standardized definition for nephrotoxicity. Conclusions: Teicoplanin and vancomycin are equally effective; however the incidence of nephrotoxicity and other adverse events was lower with teicoplanin. 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