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We administered teicoplanin as specific antibiotic therapy for nosocomial "ICU specific" infections with methicillin-resistant Staphylococcus aureus and epidermidis (MRSA-MRSE). The above mentioned drug has been given to 20 patients (15 newborns and 5 not-newborns) admitted into intensive care unit during the years 1988, 1989, 1990 with MRSA-MRSE localized and/or systemic infection, affected by severe disease (RDS, pulmonary edema, congenital cardiac disease, cystic fibrosis) undergoing invasive procedures which presented high nosocomial infective risk (tracheal intubation, mechanical ventilation, venous and arterial cannulation, total parenteral nutrition, etc.). Complete recovery from systemic or localized infection (sepsis, low respiratory tract infection, high respiratory tract infection) occurred in 19 out of 20 patients, with a rate of success of 95%. Teicoplanin treatment lasted from a minimum of nine days to a maximum of thirty days. The dose was 5-6 mg/kg/die in one administration for the first three days, then 4 mg/kg/die. The tolerability of teicoplanin has proven satisfactory, since we had no major side effects during treatment and follow up.

The authors have evaluated the efficacy and tolerance of teicoplanin against Gram-positive infections in 8 patients (four with endocarditis, one with cholangitis, one with purulent arthritis, one with gathered fistula and one with general pyoderma), arose both in the immunocompetent and immunodepressed subjects. All patients received IM teicoplanin at a dosage of 200-400 mg/die, according to the severity of the infectious process. Teicoplanin proved to be an effective and well-tolerated drug in the treatment of staphylococcus infections, both for immunocompetent and with serious deficit of the immune system subjects.

In this study the clinical microbiologic efficacy of a new antibiotic, Teicoplanin, has been reported. Teicoplanin was given to both male and female patients (200 or 400 mg/die doses) suffering from ORL infections. The microbial flora of the inflammatory focus was checked before and after antibiotic administration. Complete microbiologic eradication occurred in 13 cases of the 18 examined; in 3 cases was observed reinfection and in 2 cases the isolates were not sensitive to the antibiotic tested.

To improve our understanding of the bases of teicoplanin resistance we studied a "one-step" mutant of S. haemolyticus from a morphological point of view. The results show that the organization of peptidoglycan is altered in the resistant S. haemolyticus strain. It is suggested that the alterations, including the spongier cell wall structure, may prevent the teicoplanin from reaching its target.

Teicoplanin is a new antibiotic isolated from the fermentation broth of Actinoplanes teichomyceticus nov. sp. It's a glycopeptide antibiotic belonging to the same family as vancomycin, active against Gram-positive bacteria. The antimicrobial activity of this drug was evaluated in 32 patients suffering from different infections due to Gram-positive bacteria. Among the 36 Gram-positive microorganisms isolated, 15 staphylococci were methicillin resistant, 10 were sensitive, 1 was intermediate and for another one the methicillin susceptibility was not evaluated. After the treatment with teicoplanin, cure and improvement occurred in 26 cases (81%), in 2 cases the therapy failed (6%), in 2 cases there was a relapse and 2 cases were not evaluable. From this clinical study Teicoplanin results safe and effective in the therapy of Gram-positive infections.