Administration of parenteral
antibiotics to outpatients is increasingly used to reduce hospital costs, to reduce loss of earnings for the patient and to improve the quality of life in patients requiring prolonged
antibiotic treatment. The
glycopeptides are required for treatment of
infections caused by methicillin resistant staphylococci and some enterococci, or for treatment of patients allergic to
beta-lactam agents. For home
therapy,
teicoplanin has some advantages over
vancomycin in that it requires only once-daily bolus administration, does not necessitate monitoring of serum concentrations and offers the choice of intravenous or intramuscular administration.
Teicoplanin has been used to complete treatment of
endocarditis at home in selected patients, streptococcal disease being the most suitable form of
endocarditis for this treatment. In open trials,
teicoplanin has been found effective in home
therapy of
osteomyelitis but, as with other agents, prolonged dosage can be associated with adverse effects. It has also been used for home treatment of
infections of the respiratory tract, intravascular
catheters and soft tissue. Despite its higher acquisition costs,
teicoplanin is to be preferred over
vancomycin because of the reduced administration and assay costs and fewer adverse effects.