Teicoplanin
A glycopeptide antibiotic used widely outside the US
Teicoplanin is a glycopeptide antibiotic closely related to vancomycin, used outside the US for serious Gram-positive infections such as MRSA. A meta-analysis of randomised trials found it as effective as vancomycin with fewer adverse events, including less kidney damage. It has never been approved by FDA.
What is it?
Vancomycin and teicoplanin are the two glycopeptides in clinical use for infections caused by invasive beta-lactam-resistant Gram-positive organisms, as a 2009 meta-analysis puts it. Teicoplanin is used outside the US, but an openFDA search of Drugs@FDA finds no US approval, so American clinicians use vancomycin or newer lipoglycopeptides such as dalbavancin, oritavancin and telavancin instead.
A meta-analysis of randomised trials comparing the two found teicoplanin not inferior to vancomycin for efficacy, with significantly fewer total adverse events (risk ratio 0.61), less nephrotoxicity (risk ratio 0.44) and less red man syndrome. In nosocomial pneumonia, pooled trials found linezolid and the glycopeptides, vancomycin or teicoplanin, gave similar clinical cure rates. A second pooled analysis of twelve trials found no significant difference in clinical cure (risk ratio 1.08) but better microbiological eradication with linezolid than with the glycopeptides.
Getting enough drug into the blood early matters. One study found that reaching trough concentrations of 15 to 30 mg/L required five loading doses at 12-hour intervals in patients with normal kidney function, and patients at or above 15 mg/L tended to respond better (80.9% against 68.6%), without more kidney or liver toxicity.
At a Glance
Every value in this table is printed from the Grey Peptides dataset, the same record the compound explorer and comparison tool read, so the three can never disagree.
Educational information, not medical advice. The doses on this page come from approved labels, published studies and, where no study exists, amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
Published Research
Studies of teicoplanin, from their PubMed abstracts.
Against vancomycin: meta-analysis
Across randomised trials, teicoplanin was not inferior to vancomycin for efficacy, with fewer total adverse events (RR 0.61), less nephrotoxicity (RR 0.44) and less red man syndrome.
Loading doses and trough levels
Five loading doses of 10-12 mg/kg at 12-hour intervals were needed to reach troughs of 15-30 mg/L; patients at 15 mg/L or more tended to respond better (80.9% vs 68.6%), with nephrotoxicity of 1.3% and 3.3% across regimens.
Nosocomial pneumonia vs linezolid
Across nine trials (2,329 patients), linezolid and the glycopeptides vancomycin or teicoplanin gave similar clinical cure (RR 1.01) and microbiological eradication.
MRSA bacteraemia vs linezolid
A systematic review and meta-analysis compared linezolid with vancomycin, teicoplanin or daptomycin for MRSA bacteraemia, given linezolid's superior tissue penetration.
Nosocomial pneumonia: twelve trials
Across twelve randomised trials of linezolid against vancomycin or teicoplanin, clinical cure did not differ significantly (RR 1.08, p = 0.06), but microbiological eradication was better with linezolid.
Side Effects & Contraindications
Reported Side Effects
From the studies above.
Contraindications & Cautions
No US label; it is not approved in the US.
Legal Status
Teicoplanin is not approved in the US.
Frequently Asked Questions
?Is teicoplanin the same as vancomycin?
No, but they are close relatives: both are glycopeptide antibiotics that block cell-wall building in Gram-positive bacteria.
?Is teicoplanin safer than vancomycin?
In a meta-analysis of randomised trials it caused fewer adverse events overall, less kidney damage and less red man syndrome, with similar effectiveness.
?Why isn't teicoplanin available in the US?
It has no FDA approval; Drugs@FDA lists no teicoplanin product. It is used in Europe and elsewhere.
?Why are loading doses used?
Teicoplanin takes time to reach effective blood levels. One study found five loading doses of 10-12 mg/kg at 12-hour intervals were needed to reach trough levels of 15 to 30 mg/L in patients with normal kidney function.
?Is linezolid better than teicoplanin for hospital pneumonia?
Pooled trials found similar clinical cure rates; one analysis of twelve trials found better bacterial eradication with linezolid, without a significant difference in cure.
?What kidney monitoring is needed?
Teicoplanin caused less nephrotoxicity than vancomycin in pooled trials, and in the loading-dose study nephrotoxicity was 1.3% and 3.3% across two regimens, but kidney function still guides dosing.
References
- [fda] US FDA, Drugs@FDA via openFDA: search for generic name teicoplanin returned no records. Read October 3, 2026.
- [pubmed] Svetitsky S, et al. "Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis." Antimicrob Agents Chemother, 2009;53(10):4069-79. PMID: 19596875.
- [pubmed] Ueda T, et al. "High-dose regimen to achieve novel target trough concentration in teicoplanin." J Infect Chemother, 2014;20(1):43-7. PMID: 24462424.
- [pubmed] Kalil AC, et al. "Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis." Crit Care Med, 2010;38(9):1802-8. PMID: 20639754.
- [pubmed] Kawasuji H, et al. "Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant Staphylococcus aureus Bacteremia: A Systematic Review and Meta-Analysis." Antibiotics (Basel), 2023;12(4). PMID: 37107059.
- [pubmed] Jiang H, et al. "Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: meta-analysis of randomised controlled trials." Eur J Clin Microbiol Infect Dis, 2013;32(9):1121-8. PMID: 23568605.
Sources & Citations
Studies were read from their PubMed records; the FDA check is listed below, read October 3, 2026.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Consult a licensed healthcare provider before making health decisions.