Retrospective study of teicoplanin loading regimen that rapidly achieves target 15–30 μg/mL serum trough concentration

Kato, Hideo; Hamada, Yukihiro; Hagihara, Mao; Hirai, Jun; Nishiyama, Naoya; Koizumi, Yusuke; Yamagishi, Yuka; Matsuura, Keiichi

doi:10.1016/j.jiac.2016.01.019

Cited by 25 publications

(43 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The demographic characteristics in the Wang et al study showed that the albumin level was lower than that in the present study, which was 29 g/L and 32 g/L, respectively. It has been demonstrated that hypoalbuminaemia can cause increase in unbound teicoplanin concentration, and then increase in C min . On the other hand, the CL CR in the Wang et al study was lower than that in our study, which was 14 mL/min and 63 mL/min, respectively, and indicated that the existence of renal dysfunction was present in most of the patients in the Wang et al study.…”

Section: Discussioncontrasting

confidence: 75%

“…We have listed the main research results about teicoplanin higher loading regimen in Table 5. 6,9,10,[18][19][20][21] With the same loading regimen as in the current study, the percentage to reach target C min on day 2 in the Wang et al 9 study was slightly higher than that in the present study, which was 90.0% and 83.7%, respectively. The demographic characteristics in the Wang et al study showed that the albumin level was lower than that in the present study, which was 29 g/L and 32 g/L, respectively.…”

Section: Discussioncontrasting

confidence: 43%

“…Since the teicoplanin C min level was closely related to clinical outcome, and higher loading doses were warranted to obtain target C min , many authors have focused on how to rapidly reach target C min by modulation of loading regimen. We have listed the main research results about teicoplanin higher loading regimen in Table . With the same loading regimen as in the current study, the percentage to reach target C min on day 2 in the Wang et al study was slightly higher than that in the present study, which was 90.0% and 83.7%, respectively.…”

Section: Discussionmentioning

confidence: 41%

See 2 more Smart Citations

Optimal teicoplanin loading regimen to rapidly achieve target trough plasma concentration in critically ill patients

Gao

Zhou

et al. 2019

Basic Clin Pharma Tox

View full text Add to dashboard Cite

Teicoplanin is used for the treatment of Methicillin‐resistant Staphylococcus aureus infection. It has been demonstrated that conventional loading regimen was insufficient for teicoplanin to achieve target trough plasma concentration (Cmin > 10 mg/L). Therefore, a Chinese expert group recommended an optimal loading dose regimen of teicoplanin to treat severe Gram‐positive infection. However, there was no report about the teicoplanin concentration, and the safety and efficacy of teicoplanin therapy in Chinese patients since the consensus was published. The objective of this study was to compare the teicoplanin Cmin and clinical response in critically ill Chinese patients after the administration of conventional or optimal loading regimen, and to reveal the potential factors that may affect teicoplanin Cmin in addition to loading regimen. Fifty‐five patients were retrospectively divided into two groups based on teicoplanin loading regimen: (a) CD group (conventional loading dose group, n = 18, loading dose was 400 mg); (b) OD group (optimal loading dose group, n = 37, loading dose was 800 mg). Initially, three loading doses were administered every 12 hours, while the fourth loading dose was injected 24 hours after the third dose. The maintenance dose was 400 mg (CD group) or 800 mg (OD group), respectively. The mean teicoplanin Cmin on day 2 and day 4 in the OD group was significantly higher than those in the CD group, which were 14.75 ± 5.93 mg/L vs 8.26 ± 4.87 mg/L (P < .001) and 14.90 ± 5.20 mg/L vs 9.13 ± 4.75 mg/L (P = .019), respectively. The percentages of patients in the OD group achieving the target teicoplanin Cmin on day 2 and day 4 were also significantly higher than those in the CD group, which were 83.7% vs 33.3% (P < .001) and 82.4% vs 28.6% (P = .0013), respectively. Furthermore, multivariate linear regression analysis showed that body‐weight exerted significant effect on teicoplanin Cmin in the OD group. The percentage of favourable clinical response in the OD group was significantly higher than that in the CD group (83.8% vs 55.6%, P = .025). There was no difference between teicoplanin adverse effects in the two groups. The study demonstrated that the optimal loading dose regimen of teicoplanin can rapidly reach target Cmin, and result in a good clinical efficacy and low adverse effect in critically ill Chinese patients.

show abstract

Section: Discussioncontrasting

confidence: 75%

Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 41%

See 1 more Smart Citation

Optimal teicoplanin loading regimen to rapidly achieve target trough plasma concentration in critically ill patients

Gao

Zhou

et al. 2019

Basic Clin Pharma Tox

View full text Add to dashboard Cite

show abstract

“…4 The clinical benefit of teicoplanin is associated with the ratio of the area under the drug concentrationtime curve (AUC) to the minimum inhibitory concentration (MIC). [8][9][10][11][12][13] Teicoplanin has a long elimination half-life (>30 hours), which leads to prolongation of the time needed to achieve a steady state. 6 The use of therapeutic drug monitoring has been recommended with a target minimum concentration (C min ) range of 15-30 mg/L, 7 but the optimal dosing regimen is not yet known.…”

mentioning

confidence: 99%

“…6 The use of therapeutic drug monitoring has been recommended with a target minimum concentration (C min ) range of 15-30 mg/L, 7 but the optimal dosing regimen is not yet known. 9,20 Recently, a higher loading dose (ࣙ600 mg) and dose adjustment based on the total body weight (ࣙ10 mg/kg) have been recommended to quickly achieve the target C min . [14][15][16][17] Therefore, an optimal loading dose is necessary to promptly achieve the target C min (>15 mg/L), 8,9,18,19 but the standard dose (400 mg of teicoplanin twice a day as a loading dose at day 1 and 400 mg once a day as the maintenance dose) is insufficient to obtain the target concentration.…”

mentioning

confidence: 99%

Population Pharmacokinetics and Pharmacodynamics of Teicoplanin and C‐Reactive Protein in Hospitalized Patients With Gram‐Positive Infections

Ogami

Tsuji

Mizoguchi

et al. 2019

Clinical Pharm in Drug Dev

View full text Add to dashboard Cite

Teicoplanin is an antibiotic agent used for the treatment of Gram-positive infections. The clinical benefit of teicoplanin is associated with its blood concentrations, but the optimal dosing regimen is not yet known. To explore the optimal individual dosing regimen, we performed a population pharmacokinetic (PK) and pharmacodynamic (PD) analysis targeting a large-scale population, including patients with a wide range of ages, body weights, and renal functions. The PK of teicoplanin was described with a 2-compartment model, and the PD of C-reactive protein (CRP) concentrations was described with a turnover maximum inhibition model. The elimination half-life of teicoplanin calculated from the final estimated parameters was 169 hours, and renal function was a significant covariate of teicoplanin clearance. The teicoplanin concentration producing 50% of the maximum inhibition of CRP production was estimated to be 2.66 mg/L. The minimum concentration of teicoplanin in patients with higher loading doses (15 mg/kg) reached the target range (15-30 mg/L) with a probability of >50% in the dosing simulation. We described the influence of body size, body composition, and renal function on the PK of teicoplanin. The population PKPD model of teicoplanin and CRP in this study should provide useful information for development of a dosing strategy including the sequential clinical benefit of teicoplanin. KeywordsC-reactive protein, pharmacodynamics, pharmacokinetics, teicoplanin, therapeutic drug monitoring Teicoplanin, a glycopeptide antibiotic agent first approved in France and Italy in 1988, is currently available and used in over 60 countries for the treatment of Gram-positive infections including methicillinresistant Staphylococcus aureus. 1 Teicoplanin has a structure and a mechanism similar to those of vancomycin, another glycopeptide antibacterial agent, and exhibits bactericidal activity by inhibiting the synthesis of cell wall peptidoglycan. 2 A meta-analysis study comparing the efficacy and toxicity of teicoplanin and vancomycin revealed no significant differences in efficacy between these 2 drugs, but adverse events (eg,

show abstract

Personalized application of antimicrobial drugs in pediatric patients with augmented renal clearance: a review of literature

Xu,

Qu,

Teng

et al. 2023

Eur J Pediatr

View full text Add to dashboard Cite

Retrospective study of teicoplanin loading regimen that rapidly achieves target 15–30 μg/mL serum trough concentration

Cited by 25 publications

References 15 publications

Optimal teicoplanin loading regimen to rapidly achieve target trough plasma concentration in critically ill patients

Optimal teicoplanin loading regimen to rapidly achieve target trough plasma concentration in critically ill patients

Population Pharmacokinetics and Pharmacodynamics of Teicoplanin and C‐Reactive Protein in Hospitalized Patients With Gram‐Positive Infections

Personalized application of antimicrobial drugs in pediatric patients with augmented renal clearance: a review of literature

Contact Info

Product

Resources

About