Infect Chemother.  2014 Mar;46(1):35-41. 10.3947/ic.2014.46.1.35.

Therapeutic Drug Concentrations of Teicoplanin in Clinical Settings

Affiliations
  • 1Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. ljinsoo@medimail.co.kr
  • 2Department of Pharmacy, Inha University Hospital, Incheon, Korea.
  • 3Inha University Hospital Clinical Trial Center, Incheon, Korea.

Abstract

BACKGROUND
Teicoplanin is a glycopeptide antibiotic that is widely used in clinical practice for the treatment of infections caused by drug-resistant Gram-positive bacteria. The aim of this study was to analyze plasma teicoplanin concentrations to determine the percentage of patients in whom therapeutic concentrations of teicoplanin were achieved in clinical practice.
MATERIALS AND METHODS
The plasma teicoplanin concentrations of hospitalized patients receiving treatment at a teaching hospital were retrospectively analyzed. The target level was defined as a plasma teicoplanin concentration of 10 mg/L or greater, since this was generally regarded as the lower limit of the optimal concentration range required for the effective treatment of a majority of infections.
RESULTS
Patients with sub-optimal (< 10 mg/L) plasma teicoplanin concentrations constituted nearly half of the total study population. The majority of these patients received the recommended loading dose, which were three 400 mg doses administered every 12 hours. Sub-group analysis showed a trend that the group receiving loading dose was more likely to reach the optimal teicoplanin concentration.
CONCLUSIONS
The data revealed that a significant proportion of patients in clinical practice achieved only sub-optimal teicoplanin concentrations, which emphasizes the importance of the mandatory use of loading dose and routine therapeutic drug monitoring. Treatment reassessment and simulation of individual dose regimens may also be necessary to achieve optimal drug concentrations.

Keyword

Teicoplanin; Drug monitoring; Loading dose; Dosing regimen

MeSH Terms

Drug Monitoring
Gram-Positive Bacteria
Hospitals, Teaching
Humans
Plasma
Retrospective Studies
Teicoplanin*
Teicoplanin

Cited by  2 articles

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J Korean Med Sci. 2020;35(46):e376.    doi: 10.3346/jkms.2020.35.e376.

Is Therapeutic Drug Monitoring of Teicoplanin Useful?
Shin-Woo Kim
Infect Chemother. 2014;46(1):64-65.    doi: 10.3947/ic.2014.46.1.64.


Reference

1. Svetitsky S, Leibovici L, Paul M. Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis. Antimicrob Agents Chemother. 2009; 53:4069–4079.
Article
2. Cavalcanti AB, Goncalves AR, Almeida CS, Bugano DD, Silva E. Teicoplanin versus vancomycin for proven or suspected infection. Cochrane Database Syst Rev. 2010; (6):CD007022.
Article
3. Outman WR, Nightingale CH, Sweeney KR, Quintiliani R. Teicoplanin pharmacokinetics in healthy volunteers after administration of intravenous loading and maintenance doses. Antimicrob Agents Chemother. 1990; 34:2114–2117.
Article
4. Rowland M. Clinical pharmacokinetics of teicoplanin. Clin Pharmacokinet. 1990; 18:184–209.
Article
5. Harding I, MacGowan AP, White LO, Darley ES, Reed V. Teicoplanin therapy for Staphylococcus aureus septicaemia: relationship between pre-dose serum concentrations and outcome. J Antimicrob Chemother. 2000; 45:835–841.
Article
6. Darley ES, MacGowan AP. The use and therapeutic drug monitoring of teicoplanin in the UK. Clin Microbiol Infect. 2004; 10:62–69.
Article
7. Gilbert DN, Wood CA, Kimbrough RC. Failure of treatment with teicoplanin at 6 milligrams/kilogram/day in patients with Staphylococcus aureus intravascular infection. The Infectious Diseases Consortium of Oregon. Antimicrob Agents Chemother. 1991; 35:79–87.
Article
8. Tobin CM, Lovering AM, Sweeney E, MacGowan AP. Analyses of teicoplanin concentrations from 1994 to 2006 from a UK assay service. J Antimicrob Chemother. 2010; 65:2155–2157.
Article
9. Pea F, Brollo L, Viale P, Pavan F, Furlanut M. Teicoplanin therapeutic drug monitoring in critically ill patients: a retrospective study emphasizing the importance of a loading dose. J Antimicrob Chemother. 2003; 51:971–975.
Article
10. Wilson AP, Grneberg RN, Neu H. Dosage recommendations for teicoplanin. J Antimicrob Chemother. 1993; 32:792–796.
Article
11. Greenberg RN. Treatment of bone, joint, and vascular-access-associated gram-positive bacterial infections with teicoplanin. Antimicrob Agents Chemother. 1990; 34:2392–2397.
Article
12. Wilson AP. Clinical pharmacokinetics of teicoplanin. Clin Pharmacokinet. 2000; 39:167–183.
Article
13. Niwa T, Imanishi Y, Ohmori T, Matsuura K, Murakami N, Itoh Y. Significance of individual adjustment of initial loading dosage of teicoplanin based on population pharmacokinetics. Int J Antimicrob Agents. 2010; 35:507–510.
Article
14. Yamada T, Nonaka T, Yano T, Kubota T, Egashira N, Kawashiri T, Oishi R. Simplified dosing regimens of teicoplanin for patient groups stratified by renal function and weight using Monte Carlo simulation. Int J Antimicrob Agents. 2012; 40:344–348.
Article
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