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- Title
Comparative efficacy and safety of vancomycin versus teicoplanin in febrile neutropenic patients receiving hematopoietic stem cell transplantation.
- Authors
Kato‐Hayashi, Hiroko; Niwa, Takashi; Ohata, Koichi; Harada, Saki; Matsumoto, Takuro; Kitagawa, Junichi; Tsurumi, Hisashi; Suzuki, Akio
- Abstract
What is known and objective: Patients who receive hematopoietic stem cell transplantation (HSCT) are usually administered a calcineurin inhibitor. Because vancomycin is associated with an increased incidence of nephrotoxicity, neutropenic patients receiving HSCT are considered a high‐risk population for nephrotoxicity with vancomycin. We retrospectively compared the efficacy and safety of vancomycin and teicoplanin in febrile neutropenic patients receiving HSCT. Methods: A single‐centre, retrospective cohort study was conducted at the 614‐bed Gifu University Hospital in Japan. Patients who received HSCT and were administered vancomycin or teicoplanin by injection for febrile neutropenia from 1 January 2012 to 31 August 2017 were enrolled. Time to attain an effective trough concentration, clinical efficacy and adverse events were compared between the two groups. Results: Time to attain an effective trough concentration of over 10 μg/mL tended to be shorter in the teicoplanin group than in the vancomycin group (median 3, 95% confidence interval [CI] 2.4‐3.6 days vs median 6, 95% CI 1.5‐10.5 days; hazard ratio [HR] 0.4, 95% CI 0.15‐1.06; P = .066). The rate of clinical failure was lower in the teicoplanin group than in the vancomycin group (18.8% vs 53.8%, P = .113). In addition, the overall incidence of nephrotoxicity was significantly lower in the teicoplanin group (0% vs 46.2%, P = .004). What is new and conclusion: Our findings suggest that administration of teicoplanin may lead to early attainment of the effective concentration with a lower rate of clinical failure and incidence of nephrotoxicity compared to vancomycin in febrile neutropenic patients receiving HSCT.
- Subjects
JAPAN; ACADEMIC medical centers; CONFIDENCE intervals; FEBRILE neutropenia; HEMATOPOIETIC stem cell transplantation; LONGITUDINAL method; NEPHROTOXICOLOGY; PEPTIDES; TREATMENT effectiveness; VANCOMYCIN; DISEASE incidence; RETROSPECTIVE studies; ODDS ratio; THERAPEUTICS
- Publication
Journal of Clinical Pharmacy & Therapeutics, 2019, Vol 44, Issue 6, p888
- ISSN
0269-4727
- Publication type
Article
- DOI
10.1111/jcpt.13011