PHC-022 practical Use of Therapeutic Drug Monitoring of Teicoplanin

Abstract

Background The trough concentration of teicoplanin should be >10 mg/L for successful treatment, although it needs to be >20 mg/L for more severe staphylococcal infections, such as endocarditis and osteomyelitis. Purpose To analyse the trough serum concentrations for teicoplanin by therapeutic drug monitoring (TDM) in current clinical practise in our hospital. Materials and Methods Descriptive, analytical, observational study involving the first determination of trough serum concentration of teicoplanin, intravenously administered, from 2010 to 2012. ResultsTrough serum concentrations of teicoplanin from 48 inpatients (56.3% female) were analysed. The mean age was 59.8 years (CI95%: 55.7–63.9). 58.3% of the inpatients received one single loading dose of 800 mg, the other 37.5% received 400 mg twice daily for the first day, one patient (2.1%) 400 mg twice daily for two days and another patient (2.1%) 400 mg each day. 70.8% of inpatients continued with 400 mg twice daily, 25% with 400 mg once daily and the rest with 200 mg once daily. The mean dose was 6.9 mg/kg/day (CI95%: 5.4–8.5 mg/kg/day). The number of doses received until the first determination was 4.7 (CI95%: 4.1–5.3 doses) It was observed that the 37.5% of inpatients had a trough serum concentration of teicoplanin lower than 10 mg/L, 58.3% between 10–25 mg/L and 4.2% greater than 25 mg/L. 64.3% of the patients received 400 mg once daily and 26.5% had doses of 400 mg twice daily and had concentrations lower than 10 mg/L. All patients with concentrations lower than 10 mg/L were readjusted in their dose and frequency to reach serum trough concentrations greater than 10 mg/L, in steady-state. Conclusions We found out one problem in our setting. The current TDM of teicoplanin can help to solve it, diminishing the risk of treatment failure or micobiological resistance to teicoplanin. No conflict of interest.