OBJECTIVE To explore the clinical efficacy, concentration monitoring and safety of teicoplanin and linezolid in the treatment of gram-positive bacterial infection in patients with renal insufficiency.

METHODS A total of 83 patients with renal insufficiency infected with gram-positive bacteria admitted to the department of intensive care medicine in Suzhou Municipal Hospital from Jun 2018 to Mar 2023 were recruited. They were divided into two groups, including the teicoplanin treatment group with 43 cases and the linezolid treatment group with 40 cases. A comparative analysis is conducted between the two cohorts, encompassing parameters such as clinical treatment efficacy, gram-positive bacterial eradication rates, blood trough concentration monitoring, and the incidence of adverse reactions.

RESULTS The difference in the clinical efficacy and 28-day mortality rate between the teicoplanin and linezolid treatment groups was not statistical significant. However, there was significant difference in the eradication rate for gram-positive bacteria, with the eradication rates of 72.1% and 90.0%, respectively (P=0.039). The difference in the incidence of adverse drug reactions between the teicoplanin and linezolid treatment groups was statistically significant (P < 0.001). Platelet reduction was the predominant adverse reaction in the linezolid treatment group (42.5%). The rates of standard and elevated blood concentrations in the teicoplanin treatment group are 79.1% and 7.0%, respectively, while those in the linezolid treatment group were 2.5% and 92.5%, respectively, with statistically significant differences (all P < 0.001).

CONCLUSION In patients with renal insufficiency complicated with gram-positive bacterial infections, drug safety of teicoplanin is higher than that of linezolid, while the anti-infective efficacy of linezolid is superior than that of teicoplanin, albeit with a relatively higher incidence of elevated blood concentrations and adverse drug reactions.