A critical review of the dosage of teicoplanin in Europe and the USA

Wilson, A.P.R.; Grüneberg, R. N.; Neu, H C

doi:10.1016/0924-8579(94)90049-3

Cited by 98 publications

(72 citation statements)

References 110 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There seems to be little difference between the glycopeptides provided that teicoplanin is dosed appropriately, especially for cases of endocarditis (319). In a recent systematic review and meta-analysis, all-cause mortality rates were similar between teicoplanin and vancomycin treatments, with significantly greater toxicity when vancomycin was prescribed (283).…”

Section: Antibiotic Choicementioning

confidence: 99%

Predictors of Mortality in Staphylococcus aureus Bacteremia

et al. 2012

View full text Add to dashboard Cite

SUMMARY Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes.

show abstract

Section: Antibiotic Choicementioning

confidence: 99%

Predictors of Mortality in Staphylococcus aureus Bacteremia

et al. 2012

View full text Add to dashboard Cite

show abstract

“…The correlations between doses and pharmacokinetic profiles of glycopeptides in humans are well described, but the correlation between the pharmacokinetic profile and the effect of treatment of patients has not been fully elucidated (1,12,16,26,28). Because of fear of toxic effects, it was previously recommended that serum drug concentrations be monitored regularly during glycopeptide therapy, at least as trough concentrations but eventually also as peak concentrations (1,6,7,12,16,26,28,29).…”

mentioning

confidence: 99%

“…Because of fear of toxic effects, it was previously recommended that serum drug concentrations be monitored regularly during glycopeptide therapy, at least as trough concentrations but eventually also as peak concentrations (1,6,7,12,16,26,28,29). The effect of treatment has been correlated to dose and serum drug concentrations, but most studies have been retrospective and have focused on treatment failures and the correlation to serum drug concentrations (1,6,7,12,16,26,28,29). It has not been possible to conclude which one or more of the pharmacokinetic or pharmacodynamic (PK/PD) parameters are the most important and best predictors for the effects of treatment in humans (1,6,12,16,26,28).…”

mentioning

confidence: 99%

Pharmacodynamics of Glycopeptides in the Mouse Peritonitis Model ofStreptococcus pneumoniaeorStaphylococcus aureusInfection

Knudsen

Fuursted

Raber

et al. 2000

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The emergence of resistance to various antibiotics in pneumococci leaves the glycopeptides as the only antibiotics against which pneumococci have no resistance mechanism. This situation has led to a renewed interest in the use of glycopeptides. It has not yet been possible to conclude which one or more of the pharmacokinetic or pharmacodynamic (PK/PD) parameters are the most important and best predictors for the effects of treatment with glycopeptides in animal models or in humans. We used the mouse peritonitis model with immunocompetent mice and with Staphylococcus aureus and Streptococcus pneumoniae as infective organisms. A wide spectrum of different treatment regimens with vancomycin and teicoplanin was tested to study the pharmacodynamics of these drugs. In studies in which the single dose that protected 50% of lethally infected mice (ED 50 ) was given as one dose or was divided into two doses, survival was significantly decreased when the dose was divided. The only statistically significant correlations between the percentage of survival of the mice after 6 days and each of the PK/PD parameters were for peak concentration (C max )/MIC and S. aureus and for the free fraction of C max (C max-free )/MIC and S. pneumoniae. For S. pneumoniae, the ED 50 for different dosing regimens increased with the number of doses given; e.g., the single-dose ED 50 s for vancomycin and teicoplanin were 0.65 and 0.45 mg/kg, respectively, but the ED 50 s for dosing regimens with 2-h doses given for 48 h were 6.79 and 5.67 mg/kg, respectively. In experiments with 39 different vancomycin dosing regimens and 40 different teicoplanin dosing regimens against S. pneumoniae, the different PK/PD parameters were analyzed using logistic regression. The C max-free /MIC was one of two parameters that best explained the effect for both drugs; for vancomycin, the other important parameter was the AUC/MIC, and for teicoplanin, the other parameter was the time the free fraction of the drug is above the MIC. The effect analyzed as a function of C max-free /MIC disclosed thresholds with shifts from almost no effect to full effect at ratios of five to six for vancomycin and two to three for teicoplanin.

show abstract

“…Several studies have shown a relationship between TEIC serum concentration and clinical e‹ciency. 1,6,16) A logistic regression analysis showed that the probability of successful treatment with TEIC declined with age and increased with mean concentration at non-steady state. 5) A appropriate loading dose regimen must be considered mandatory for all patients, regardless of their renal function, to reach the range of appropriate concentrations early in the treatment period.…”

Section: Discussionmentioning

confidence: 99%

“…1) It is generally considered that the trough concentration of TEIC should be ＞10 mg/mL for MRSA infections and ＞20 mg/mL for deep-seated infections, such as endocarditis, bone and joint infection, and osteomyelitis. 2 4) Although an intravenous loading regimen for TEIC consisting of 400 mg every 12 h for theˆrst three doses has been recommended in many countries, some studies have reported to remain ＜10 15 mg/ mL.…”

Section: Introductionmentioning

confidence: 99%

Improvement of Predictivity of Teicoplanin Serum Trough Concentrations at Steady State Calculated by Vancomycin Pharmacokinetic Parameter

Kobayashi

Otomo²,

Shiba³

et al. 2016

YAKUGAKU ZASSHI

View full text Add to dashboard Cite

According to a recent study and meta-analysis, trough levels of ＞10 mg/mL teicoplanin (TEIC) may be acceptable for the treatment of uncomplicated infection, but no method of TEIC personalized medicine has been established. Vancomycin (VCM) and TEIC are glycopeptide antibiotic agents eŠective against methicillin-resistance Staphyloccocus aureus. This study aimed to establish TEIC personalized medicine at a steady state calculated by VCM pharmacokinetic parameters. Bayesian forecasting and population mean methods were employed to estimate individual total VCM clearance (CL) using existing population pharmacokinetics (PPK) parameter, and the diŠerences between the CL calculated by these two methods were deˆned as DCL. Serum drug concentration data for patients treated with TEIC were collected at a steady state concentration (＞96 h post infusion). There was a signiˆcant relationship between the prediction error of TEIC trough level and DCL. The relation between DCL and TEIC trough concentration at steady state was used to develop the following equation to determine the maintenance dose: TEIC (mg/mL)＝1.1119X-6.124DCL＋3.9164 (X is deˆned as TEIC trough concentration calculated from the PPK parameter). The results of this study indicated that it is possible to improve the prediction error of TEIC trough concentration at a steady state for patients who have received VCM therapy.

show abstract

A critical review of the dosage of teicoplanin in Europe and the USA

Cited by 98 publications

References 110 publications

Predictors of Mortality in Staphylococcus aureus Bacteremia

Predictors of Mortality in Staphylococcus aureus Bacteremia

Pharmacodynamics of Glycopeptides in the Mouse Peritonitis Model ofStreptococcus pneumoniaeorStaphylococcus aureusInfection

Improvement of Predictivity of Teicoplanin Serum Trough Concentrations at Steady State Calculated by Vancomycin Pharmacokinetic Parameter

Contact Info

Product

Resources

About