Abstract: OBJECTIVE To explore the clinical efficacy of teicoplanin and norvancomycin in the treatment of Gram-positivebacteria in patients with severe pneumonia. METHODS A total of 74 patients diagnosed with Gram-positive bacteria admitted to Nanyang Central Hospital in Henan Province from Sep. 2016 to Sep. 2018 were selected and the patients were divided into teicoplanin group and norvancomycin group by simple random sampling, with 37 cases in each group. The teicoplanin group was treated with teicoplanin and norvancomycin group was treated with norvancomycin. Both groups were continuously treated for 14 days. Before and after treatment, distribution and clearance conditions of pathogens were detected by sputum culture, the number of white blood cells（WBC） was detected by blood routine analyzer, the levels of serum tumor necrosis factor-α（TNF-α） and C-reactive protein（CRP） were detected by ELISA. Immunochromatography was performed to detect level of procalcitonin（PCT）. After treatment, the clinical efficacy and microbial efficacy in the two groups were determined. The occurrence of adverse reactions was recorded. RESULTS Prior to treatment, the major pathogens in patients with severe pneumonia were Staphylococcus aureus（44.59%）, followed by Coagulase negative Staphylococcus（29.73%）. The total effective rate of treatment in teicoplanin group was 86.49% and the pathogen clearance rate was 83.78%, respectively. The total effective rate of treatment in norvancomycin group was 75.68% and the pathogen clearance rate was 72.97%, respectively. There was no significant difference in effective rate of treatment and pathogen clearance rate between the two groups. After treatment, levels of serum WBC, TNF-α, CRP and PCT in teicoplanin group were（9.54±2.07） ×10⁹ /L、（176.22±38.59）ng/L、（47.95±7.14）mg/L、（3.94±0.89）μg/L significantly lower than those in norvancomycin group（P＜0.001）. The incidence of adverse reactions in teicoplanin group was significantly lower than that in norvancomycin group（8.11% vs 27.03%）（ P=0.032）. CONCLUSION Both teicolanin and deicolancomycin could effectively remove the pathogenic bacteria in patients with gram-positive coccal severe pneumonia, and the efficacy was similar, however, the adverse reactions of teicoplanin was significantly lower than that of norvancomycin.