Activity of teicoplanin and vancomycin against penicillin-resistant pneumococci

Abstract

There are few therapeutic options available for the management of penicillin- and cephalosporin-resistant pneumococcal disease. The glycopeptide agents vancomycin and teicoplanin remain universally active against pneumococci. Against systemic isolates vancomycin demonstrates reliable clinical efficacy, but its use in meningitis is hampered by unreliable CSF penetration. The drug may be used in combination with a third-generation cephalosporin for the treatment of meningitis in settings where resistant strains are common. More data are however required on the interaction of vancomycin and third-generation cephalosporins in the CSF of infected patients. The superior in vitro activity of teicoplanin over vancomycin suggests that further CSF penetration studies are required. Additional studies should also address the interaction of teicoplanin with third generation cephalosporins in vitro and perhaps its use as adjunctive combination therapy for resistant pneumococcal meningitis.