Evaluating the optimal dose of teicoplanin with therapeutic drug monitoring: not too high for adverse event, not too low for treatment efficacy

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
Si-Ho KimKyong Ran Peck

Abstract

Therapeutic drug monitoring (TDM) of teicoplanin is aimed at minimizing the clinical impact of pharmacokinetic variability; however, its benefits are still being defined. We performed a retrospective study of teicoplanin TDM focusing on the dose-serum concentration relationship and clinical outcomes in a clinical setting. From January 2017 to December 2018, patients receiving teicoplanin ≥ 72 h with TDM were enrolled. Patients were divided into three groups: non-loading (NL) group, low-dose loading (LD) group (loading dose < 9 mg/kg), and high-dose loading (HD) group (≥ 9 mg/kg). Serum teicoplanin trough concentration (Cmin) and adverse events (AEs) were evaluated in each regimen. A subgroup of patients with bacteremia was analyzed to evaluate clinical efficacy. Among 65 patients, 12, 18, and 35 were grouped in NL, LD, and HD, respectively. Achievement rates of Cmin > 20 mg/L within 10 days were significantly different among the groups (25.0%, 38.9%, and 68.6% in the NL, LD, and HD groups, respectively; P = 0.014). Fourteen patients (21.5%) had AEs, and higher Cmin over 10 days (adjusted odds ratio 2.08 per every 20 mg/L increases, 95% CI 1.13-3.84, P = 0.019) and age ≥ 65 years (P = 0.009) were identified as independent risk f...Continue Reading

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Citations

Apr 23, 2020·Expert Review of Clinical Pharmacology·Dario CattaneoDeborah Je Marriott
Oct 1, 2020·Journal of Personalized Medicine·Vivian GarzónDaniel G Pinacho
Oct 1, 2020·European Journal of Clinical Investigation·Giancarlo CeccarelliMario Venditti
May 27, 2020·International Journal of Antimicrobial Agents·Giancarlo CeccarelliUNKNOWN Intensive Care COVID-19 Study Group of Sapienza University
Oct 30, 2020·Biologics : Targets & Therapy·Desalegn Getnet DemsieDesye Gebrie
Feb 11, 2021·Clinical Pharmacology and Therapeutics·Sebastian G WichaUNKNOWN International Society of Anti-Infective Pharmacology (ISAP), the PK/PD study group of the European Society of Clinical Micro

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