替考拉宁与万古霉素在中性粒细胞缺乏伴发热的恶性血液病患儿中的有效性和安全性分析

OBJECTIVE To compare the efficacy and safety of teicoplanin and vancomycin in haematologicalmalignancy children with febrile neutropenia for empirically treating suspected gram-positive bacterial infections, to provide the choice for appropriately selecting the empirical antibiotics in clinical practice early. CONCLUSION The medical records of patients received teicoplanin/vancomycin were retrospectively collected. The baseline characteristics of the two groups were balanced using propensity score matching(1:2) to compare the clinical efficacy, the target attainment of trough concentration and the related time, as well as the incidence of nephrotoxicity of the two groups. RESULTS A total of 126 haematologicalmalignancy children with febrile neutropenia were enrolled. There were 89 and 37 patients in the teicoplanin and the vancomycin treatment group, respectively. After matching, a total of 74 patients in the teicoplanin group and 37 patients in the vancomycin group were enrolled, and there were no significant differences between the two groups in terms of the demographic data and baseline laboratory tests. There were no significant differences in the clinical effective rate at 72 h(P=0.673) and at the end of medication(P=0.477) between the two groups, and there were also no significant differences in the attainment rate of the target trough concentration and the reaching time between the two groups(P=0.439 and 0.103, respectively). However, the incidence of nephrotoxicity in teicoplanin group was significantly lower than that in the vancomycin group(P=0.026). CONCLUSION Teicoplanin is recommended to treat the suspected gram-positive bacterial infections in haematologicalmalignancy children with febrile neutropenia empirically.