Therapeutic Drug Concentrations of Teicoplanin in Clinical Settings
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Background: Teicoplanin is a glycopeptide antibiotic that is widely used in clinical practice for the treatment of infections caused bydrug-resistant Gram-positive bacteria. The aim of this study was to analyze plasma teicoplanin concentrations to determine the percentageof 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 hospitalwere retrospectively analyzed. The target level was defined as a plasma teicoplanin concentration of 10 mg/L or greater, since thiswas 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 every12 hours. Sub-group analysis showed a trend that the group receiving loading dose was more likely to reach the optimal teicoplaninconcentration. Conclusions: The data revealed that a significant proportion of patients in clinical practice achieved only sub-optimal teicoplaninconcentrations, which emphasizes the importance of the mandatory use of loading dose and routine therapeutic drugmonitoring. Treatment reassessment and simulation of individual dose regimens may also be necessary to achieve optimal drugconcentrations.
Abstract
Background: Teicoplanin is a glycopeptide antibiotic that is widely used in clinical practice for the treatment of infections caused bydrug-resistant Gram-positive bacteria. The aim of this study was to analyze plasma teicoplanin concentrations to determine the percentageof 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 hospitalwere retrospectively analyzed. The target level was defined as a plasma teicoplanin concentration of 10 mg/L or greater, since thiswas 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 every12 hours. Sub-group analysis showed a trend that the group receiving loading dose was more likely to reach the optimal teicoplaninconcentration. Conclusions: The data revealed that a significant proportion of patients in clinical practice achieved only sub-optimal teicoplaninconcentrations, which emphasizes the importance of the mandatory use of loading dose and routine therapeutic drugmonitoring. Treatment reassessment and simulation of individual dose regimens may also be necessary to achieve optimal drugconcentrations.
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