Teicoplanin Versus Vancomycin in Children of Jordan: A Comparative Safety Study

Abstract

Background and Aims: Vancomycin and teicoplanin are used frequently, and their use is variably associated with known mild to severe adverse events. The aim of this study was to evaluate and compare adverse event and toxicity profiles of vancomycin and teicoplanin in children at a university hospital in Jordan. Methods: This prospective observational study evaluated 112 children aged 1 month to 15 years who received vancomycin (n = 69) or teicoplanin (n = 43). Baseline demographic, clinical and laboratory data were documented. Safety data during treatment were collected and analyzed, including adverse events and laboratory markers. Results: Baseline characteristics of subjects were fairly balanced except for hemoglobin levels. More adverse events were observed in the vancomycin patients (64% vs. 44%; p = 0.02). Vancomycin was associated with a significantly higher rate of pyrexia (55% vs. 30%; p = 0.01) and a trend toward a higher rate of gastrointestinal adverse events. On the other hand, there was no significant difference in hemoglobin levels, white blood cell counts, neutrophils counts, and platelets counts between the two groups during treatment. Nephrotoxicity occurred in both vancomycin and teicoplanin arms, with no statistically significant difference (14% vs. 27%; p = 0.48). Conclusion: Both drugs were fairly well-tolerated by children, with fewer serious adverse events than previously reported. Statistically, nephrotoxicity occurred equally in both arms. However, vancomycin was associated with a significantly higher rate of adverse events. Accordingly, and due to study limitations, there is a need for a large-scale, randomized study in children to better understand the safety profiles of both drugs.