Development of a teicoplanin loading regimen that rapidly achieves target serum concentrations in critically ill patients with severe infections

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
Atsuo NakamuraMikinori Kannae

Abstract

We performed high-dose loading (12 mg/kg every 12 h for 48 h; 4 doses total) of teicoplanin (TEIC) in patients with severe methicillin-resistant Staphylococcus aureus (MRSA) infections, with the goal of achieving target serum concentration (TEICc) ≥ 15 mg/l within 48 h of starting administration. The safety and effectiveness of the fixed, early-stage administration method were evaluated across a range of kidney dysfunction severity levels. TEIC high-dose loading was administered to 106 patients with MRSA infection from February 2010 to February 2013. After high-dose loading, maintenance doses based on therapeutic drug monitoring (TDM) of TEICc were administered via 30-min intravenous drips, every 24 h. Subjects were divided into 4 groups based on kidney function and renal replacement therapy (RRT) status for safety and effectiveness evaluation: group 1 (G1) did not undergo RRT and exhibited creatinine clearance (Ccr; ml/min/m(2)) >50, group 2 (G2) exhibited Ccr ≤ 50, group 3 (G3) underwent continuous RRT (CRRT), and group 4 (G4) underwent intermittent RRT (IRRT). TEICc was measured after 24, 48, 72, and 144 h, immediately before TEIC administration. Target TEICc was reached in all groups, and bacteriological effectiveness and u...Continue Reading

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Citations

Mar 11, 2016·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hideo KatoHiroshige Mikamo
Jun 10, 2016·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T UedaT Kimura
Aug 3, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Si-Ho KimKyong Ran Peck
Oct 30, 2021·Basic & Clinical Pharmacology & Toxicology·Toshinori HiraiTakuya Iwamoto

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