Abstract
Background and objectiveThe efficacy of vancomycin vs. teicoplanin for the successful treatment of febrile neutropenia (FN) has been a subject of debate in the medical community. In light of this, we performed a systematic review and meta-analysis to compare these two medications in the treatment of patients with FN in terms of treatment success and adverse events.Data source and study designWe conducted a search of major electronic databases [MEDLINE (PubMed, Ovid), Google Scholar, clinicaltrial.org], which returned 10 studies with 1,630 patients (vancomycin: 788; teicoplanin: 842) for analysis. An unadjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated for all studies, as well as separate sub-analyses of randomized controlled trials (RCTs) and retrospective studies.ResultsThe average age of patients ranged from 37 to 57 years in the vancomycin group and 31 to 57 years in the teicoplanin group (n=9 studies). Over half of the patients in both groups were male (vancomycin: 55.6%; teicoplanin: 57.7%; n=9 studies). Both overall evaluation and sub-analyses revealed that both treatments were comparable in terms of treatment success, nephrotoxicity, and red man syndrome. The vancomycin group was more likely to develop skin rashes (OR: 2.49; 95% CI: 1.28-4.83). The heterogeneity for all analyses ranged from 0-47.4%.ConclusionOur analysis showed that vancomycin and teicoplanin showed comparable results in terms of successful treatment of FN. Adverse effects such as nephrotoxicity and red man syndrome were also comparable between the two treatment groups.
Highlights
The Infectious Diseases Society of America (IDSA) defines febrile neutropenia (FN) as a single oral temperature of ≥38.3 °C (101 °F) or a temperature of ≥38.0 °C (100.4 °F) sustained over a period of one hour [1]
The vancomycin group was more likely to develop skin rashes (OR: 2.49; 95% confidence interval (CI): 1.28-4.83)
Our analysis showed that vancomycin and teicoplanin showed comparable results in terms of successful treatment of FN
Summary
The Infectious Diseases Society of America (IDSA) defines febrile neutropenia (FN) as a single oral temperature of ≥38.3 °C (101 °F) or a temperature of ≥38.0 °C (100.4 °F) sustained over a period of one hour [1]. The risk for infections is higher in patients with ANC of 7 days) [1]. Documented infection is FN with a clinical focus but without isolating an associated pathogen, and unexplained fever is FN without a microbial or clinical focus [1]. The most common factors contributing to the development of neutropenic fever in cancer patients include the direct effects of chemotherapy on mucosal barriers and breeches in the host defenses, which increase the risk of invasive infection. The efficacy of vancomycin vs teicoplanin for the successful treatment of febrile neutropenia (FN) has been a subject of debate in the medical community. We conducted a search of major electronic databases [MEDLINE (PubMed, Ovid), Google Scholar, clinicaltrial.org], which returned 10 studies with 1,630 patients (vancomycin: 788; teicoplanin: 842) for analysis. An unadjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated for all studies, as well as separate sub-analyses of randomized controlled trials (RCTs) and retrospective studies
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