Benjamin Davido1, Céline Leplay2, Frédérique Bouchand2, Aurélien Dinh3, Maryvonne Villart2,4, Jean-Laurent Le Quintrec5, Laurent Teillet5, Jérôme Salomon3, Hugues Michelon2,4. 1. Maladies Infectieuses, Hôpital Universitaire Raymond-Poincaré, AP-HP, 92380, Garches, France. benjamin.davido@aphp.fr. 2. Pharmacie Hospitalière, Hôpital Universitaire Raymond-Poincaré, AP-HP, 92380, Garches, France. 3. Maladies Infectieuses, Hôpital Universitaire Raymond-Poincaré, AP-HP, 92380, Garches, France. 4. Pharmacie Hospitalière, Hôpital Universitaire Sainte-Périne, AP-HP, 75016, Paris, France. 5. Médecine Gériatrique, Hôpital Universitaire Sainte-Périne, AP-HP, 75016, Paris, France.
Abstract
BACKGROUND: Elderly patients are more susceptible to Clostridium difficile infections (CDIs). Despite existing guidelines, there is no specific treatment for CDI in geriatrics. Vancomycin is commonly used in the treatment of CDI. Teicoplanin is an alternative glycopeptide which recently received marketing authorization approval for CDI in Europe. OBJECTIVES: Evaluate the potential interest of oral teicoplanin and assess whether such treatment could potentially become an alternative treatment in mild to severe CDIs in elderly patients. METHODS: A prospective monocentric study was conducted over 10 months (from December 2015 to October 2016) in a geriatric unit (Sainte Périne, AP-HP, Paris, France). According to the remote infectious disease specialist, some hospitalized patients suffering from CDI and aged over 65 years received oral teicoplanin 200 mg twice a day (highest dose recommended). The clinical response to teicoplanin and relapses after treatment were evaluated. Patients were monitored up to 90 days after teicoplanin administration, and analyzed in non-responder imputation analysis. RESULTS: Eleven patients received teicoplanin among 19 CDIs during the study time period. In non-responder imputation analysis, 90.9% (n = 10) successfully responded to oral teicoplanin. The rate of relapse observed after a 90-day follow-up was 36.4%. Patients reported no drug-related adverse effects. CONCLUSION: Oral teicoplanin is a glycopeptide that could be proposed as an alternative to other recommended drugs for CDI. In our case series, teicoplanin seems to be an effective therapy as a first-line regimen for CDI in geriatrics. Such treatment has good acceptability in geriatrics, considering it can be taken orally twice a day.
BACKGROUND: Elderly patients are more susceptible to Clostridium difficile infections (CDIs). Despite existing guidelines, there is no specific treatment for CDI in geriatrics. Vancomycin is commonly used in the treatment of CDI. Teicoplanin is an alternative glycopeptide which recently received marketing authorization approval for CDI in Europe. OBJECTIVES: Evaluate the potential interest of oral teicoplanin and assess whether such treatment could potentially become an alternative treatment in mild to severe CDIs in elderly patients. METHODS: A prospective monocentric study was conducted over 10 months (from December 2015 to October 2016) in a geriatric unit (Sainte Périne, AP-HP, Paris, France). According to the remote infectious disease specialist, some hospitalized patients suffering from CDI and aged over 65 years received oral teicoplanin 200 mg twice a day (highest dose recommended). The clinical response to teicoplanin and relapses after treatment were evaluated. Patients were monitored up to 90 days after teicoplanin administration, and analyzed in non-responder imputation analysis. RESULTS: Eleven patients received teicoplanin among 19 CDIs during the study time period. In non-responder imputation analysis, 90.9% (n = 10) successfully responded to oral teicoplanin. The rate of relapse observed after a 90-day follow-up was 36.4%. Patients reported no drug-related adverse effects. CONCLUSION: Oral teicoplanin is a glycopeptide that could be proposed as an alternative to other recommended drugs for CDI. In our case series, teicoplanin seems to be an effective therapy as a first-line regimen for CDI in geriatrics. Such treatment has good acceptability in geriatrics, considering it can be taken orally twice a day.
Authors: Richard L Nelson; Philippa Kelsey; Hayley Leeman; Naomi Meardon; Haymesh Patel; Kim Paul; Richard Rees; Ben Taylor; Elizabeth Wood; Rexanna Malakun Journal: Cochrane Database Syst Rev Date: 2011-09-07
Authors: Els van Nood; Anne Vrieze; Max Nieuwdorp; Susana Fuentes; Erwin G Zoetendal; Willem M de Vos; Caroline E Visser; Ed J Kuijper; Joep F W M Bartelsman; Jan G P Tijssen; Peter Speelman; Marcel G W Dijkgraaf; Josbert J Keller Journal: N Engl J Med Date: 2013-01-16 Impact factor: 91.245
Authors: F de Lalla; R Nicolin; E Rinaldi; P Scarpellini; R Rigoli; V Manfrin; A Tramarin Journal: Antimicrob Agents Chemother Date: 1992-10 Impact factor: 5.191