A retrospective analysis to estimate trough concentrations of teicoplanin in patients with suspected or documented Gram-positive infections

Authors

  • Luo Yi-Fan the First Hospital of China Medical University, Shenyang, China
  • Wang Yi-Dan China Medical University. School of Pharmacy, Shenyang, China
  • Ren Li-Xiang Safety Evaluation Center, Shenyang Research Institute of Chemical Industry, Shenyang, China
  • Chu Yang the First Hospital of China Medical University, Shenyang, China https://orcid.org/0000-0001-5632-837X

DOI:

https://doi.org/10.1590/s2175-97902023e21077

Keywords:

Teicoplanin, HPLC, Therapeutic drug monitoring, Trough concentration , Creatinine clearance , Estimated glomerular filtration rate

Abstract

Teicoplanin is a glycopeptide antibiotic commonly used to treat Gram-positive bacterial infections in the clinic. The aim of this study was to provide a therapeutic reference for the clinical application and dosage regimen adjustment of teicoplanin by identifying factors associated with its plasma trough concentration (Ctrough). A retrospective study was performed on patients with suspected or documented Gram-positive infections who were hospitalized from November 2017 to January 2020 and treated with teicoplanin while undergoing routine therapeutic drug monitoring (TDM). A total of 112 Ctrough trough measurements were obtained from 72 patients were included in this study. SPSS software was used for correlation analysis and receiver operator characteristic curve (ROC) analysis. The Ctrough for teicoplanin showed statistically significant relationships (P<0.05) with PLT, Scr, CLcr, eGFR, BUN and Cys-C. ROC curve analysis revealed that CLcr and eGFR were more sensitive and specific for Ctrough compared to the other factors. These findings should be considered in the clinical application of teicoplanin and for its dosage adjustment.

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References

Ahn BJ, Yim DS, Lee DG, Kwon JC, Kim SH, Choi SM. Teicoplanin dosing strategy for treatment of staphylococcus aureus in Korean patients with neutropenic fever. Yonsei Med J. 2011;52(4):616-23.

Craig WA. Basic pharmacodynamics of antibacterials with clinical applications to the use of beta-lactams, glycopeptides, and linezolid. Infect Dis Clin North Am. 2003;17(3):479-501.

Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41.

Electronic Medicines Compendium. 2017. Targocid 200 mg-summary of product characteristics (SPC). https://www.medicines.org.uk/emc/product/2926/smpc2019; Accessed 25 August.

» https://www.medicines.org.uk/emc/product/2926/smpc

Foundation NK. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):S1-266.

Garner SF, Campbell K, Smith G, Hurd C, Davidson SJ, Treacy M, et al. Teicoplanin-dependent antibodies: detection and characterization. Br J Haematol. 2005;129(2):279-81.

Hsiao SH, Chou CH, Lin WL, Lee EJ, Liao LH, Chang HJ, et al. High risk of cross-reactivity between vancomycin and sequential teicoplanin therapy. J Clin Pharm Ther. 2012;37(3):296-300.

Kato H, Hamada Y, Hagihara M, Hirai J, Nishiyama N, Koizumi Y, et al. Retrospective Study of teicoplanin loading regimen that rapidly achieves target 15-30 μg/mL serum trough concentration. J Infect Chemother. 2016;22(5):308-13.

Kroll H, Sun QH, Santoso S. Platelet endothelial cell adhesion molecule-1 (PECAM-1) is a target glycoprotein in drug-induced thrombocytopenia. Blood. 2000;96(4):1409-14.

Li N, Zhu LQ, Xu GQ, Ge TY, Qi F, Li MX. Optimal teicoplanin dosage regimens for methicillin-resistant Staphylococcus aureus infections in endocarditis patients and renal failure patients. J Chemother. 2017;29(6):358-64.

Marcone GL, Binda E, Berini F, Marinelli F. Old and new glycopeptide antibiotics: from product to gene and back in the post-genomic era. Biotechnol Adv. 2018;36(2):534-54.

Matsumoto K, Watanabe E, Kanazawa N, Fukamizu T, Shigemi A, Yokoyama Y, et al. Pharmacokinetic/pharmacodynamic analysis of teicoplanin in patients with MRSA infections. Clin Pharmacol. 2016;8:15-8.

Pea F, Brollo L, Viale P, Pavan F, Furlanut M. Teicoplanin therapeutic drug monitoring in critically ill patients: a retrospective study emphasizing the importance of a loading dose. J Antimicrob Chemother. 2003;51(4):971-5.

Ponce D, Zamoner W, Freitas FM, Balbi A, Awdishu L. Vancomycin removal during high-volume peritoneal dialysis in acute kidney injury patients: a prospective cohort clinical study. Kidney Int Rep. 2018;4(1):112-8.

Ramos-Martín V, Johnson A, Mcentee L, Farrington N, Padmore K, Cojutti P, et al. Pharmacodynamics of teicoplanin against MRSA. J Antimicrob Chemother . 2017;72(12):3382-9.

Roberts JA, Norris R, Paterson DL, Kwon JC, Kim SH, Choi SM. Therapeutic drug monitoring of antimicrobials. Br JClin Pharmacol . 2012;73(1):27-36.

Sader HS, Mendes RE, Pfaller MA, Flamm RK. Antimicrobial activity of dalbavancin tested against Gram-positive organisms isolated from patients with infective endocarditis in US and European medical centres. J Antimicrob Chemother . 2019;74(5):1306-10.

Shime N, Saito N, Bokui M, Sakane N, Kamimura M, Shinohara T, et al. Clinical outcomes after initial treatment of methicillin-resistant Staphylococcus aureus infections. Infect Drug Resist. 2018;11:1073-81.

Svetitsky S, Leibovici L, Paul M. Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis. Antimicrob Agents Chemother. 2009;53(10):4069-79.

Tascini C, Flammini S, Leonildi A, Ciullo I, Tagliaferri E, Menichetti F. Comparison of teicoplanin and vancomycin in vitro activity on clinical isolates of Staphylococcus aureus. J Chemother . 2012;24(4):187-90.

Takechi K, Yanagawa H, Zamami Y, Ishizawa K, Tanaka A, Araki H. Evaluation of factors associated with the achievement of an optimal teicoplanin trough concentration. Int J Clin Pharmacol Ther. 2017;55(8):672-7.

Ueda T, Takesue Y, Nakajima K, Ichki K, Wada Y, Tsuchida T, et al. Evaluation of teicoplanin dosing designs to achieve a new target trough concentration. J Infect Chemother . 2012;18(3):296-302.

Wang T, Li N, Hu S, Xie J, Lei JE, Wang Y, et al. Factors on trough teicoplanin levels, associations between levels, efficacy and safety in patients with gram-positive infections. Int J Clin Pharmacol Ther. 2015;53(5):356-62.

Wang JT, Wu HS, Weng CM, Hsu LY, Wang FD. Prognosis of patients with methicillin-resistant Staphylococcus aureus bloodstream infection treated with teicoplanin: a retrospective cohort study investigating effect of teicoplanin minimum inhibitory concentrations. BMC Infectious Diseases. 2013;13:182.

Wood MJ. The comparative efficacy and safety of teicoplanin and vancomycin. J Antimicrob Chemother . 1996;37(2):209-22.

Wood MJ. Comparative safety of teicoplanin and vancomycin. J Chemother . 2000;12 (Suppl 5): 21-5.

Yoon YK, Park DW, Sohn JW, Kim HY, Kim YS, Lee CS, et al. Multicenter prospective observational study of the comparative efficacy and safety of vancomycin versus teicoplanin in patients with health care-associated methicillin-resistant staphylococcus aureus bacteremia. Antimicrob Agents Chemother . 2014;58(1):317-24.

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Published

2023-04-28

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Original Article

How to Cite

A retrospective analysis to estimate trough concentrations of teicoplanin in patients with suspected or documented Gram-positive infections. (2023). Brazilian Journal of Pharmaceutical Sciences, 59, e21077. https://doi.org/10.1590/s2175-97902023e21077