Antimicrobial

Teicoplanin

A long-acting glycopeptide antibiotic used in Europe for serious Gram-positive infections, with once-daily dosing.

Moderate evidenceApproved drugAdd to compare

What it is

Teicoplanin is a glycopeptide antibiotic closely related to vancomycin, used widely in Europe and the UK but not licensed in the US. Its long half-life allows one dose a day after loading, and it can be given by intramuscular injection as well as intravenously - both differences that make outpatient treatment practical.

How it works

1
Binds D-Ala-D-Ala precursors and blocks peptidoglycan cross-linking, like vancomycin.
2
Bactericidal against dividing Gram-positive bacteria.
3
Its long fatty acid chain anchors it in the bacterial membrane, which slows clearance and lengthens its half-life.
4
Not absorbed orally, so the oral form is used only for gut infections.
5
Ineffective against Gram-negative organisms.

What it's studied for

Complicated skin and soft tissue infection

Bone and joint infection, including outpatient therapy

Endocarditis caused by Gram-positive organisms

Clostridioides difficile infection (oral)

Surgical prophylaxis in some European centres

Reported and studied effects

Clinical cure rates broadly comparable to vancomycin in comparative trials
Once-daily maintenance dosing after loading
Less infusion-related flushing than vancomycin
Nephrotoxicity reported, though possibly less than with vancomycin

Research protocol notes

Research context only

Research context only - a hospital antibiotic. Loading is typically 6 mg per kilogram (up to 12 mg per kilogram for serious infection) every 12 hours for three to five doses, then once daily with dose adjustment for kidney function; trough levels are monitored in serious infection. Comparative trials assess clinical and microbiological cure at end of treatment.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

Rash, including rare severe cutaneous reactions
Thrombocytopenia
Raised liver enzymes
Nephrotoxicity
Injection-site pain
Infusion-related reactions

Contraindications and cautions

Prior hypersensitivity to glycopeptides
Dose reduction in kidney impairment
Caution in patients with a history of drug rashes
Not for Gram-negative infection

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Moderate evidenceSeveral human trials, some inconsistencies

Several human trials, some inconsistencies

Several randomised comparisons with vancomycin exist and outcomes are similar, but the trials are smaller and fewer than the vancomycin literature, and it lacks US approval.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

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