treated with the appropriate antibiotics, sepsis has a mortality of 40% (see sepsis).
Whatever the reason for using Teicoplanin, it is certainly the wrong antibiotic where Gram-negative bacteria are the most likely causes. The most commonly isolated Gram-negative bacteria from urine are the Enterobacteriaceae (e.g. E. coli, Klebsiella sp., Proteus sp.) and Pseudomonas sp.
Clinical scenarios where Teicoplanin IS appropriate as a second line antibiotic are usually caused by Staphylococci or
• Septic arthritis (especially prosthetic joint)
• Infective endocarditis
• Severe community acquired pneumonia (in combination with a quinolone)
Clinical scenarios where Teicoplanin IS NOT appropriate are usually caused by either Gram-negative bacteria alone or mixtures where Gram-negative bacteria are the main pathogens:
• Urinary tract infection
• Cholecystitis and cholangitis
Remember, Teicoplanin is only active against Gram-positive bacteria such as Staphylococcus, Streptococcus, Listeria and Enterococcus. Teicoplanin has no Gram-negative activity. It therefore should NEVER be used to treat infections caused by Gram-negative bacteria; it will just give all of the side effects (neutropaenia, thrombocytopaenia and renal failure) with none of the benefits.
To remember this try the mnemonic “Teicoplanin is active against LESS” - Listeria, Enterococcus, Staphylococcus and Streptococcus
PS If you know why Teicoplanin is wrongly used to treat UTIs, do let me know.