Clinical analysis of therapeutic drug monitoring and drug dosage for ICU patients treated with teicoplanin

Abstract

Abstract: AIM: To study the necessity of TDM and a reasonable dose of teicoplanin.METHODS: The clinical data of 20 patients who were suffered with severe infection and treated with teicoplanin were retrospectively analyzed.According to the MID, patients were divided into two groups: group1 (MID=533.33 mg/d, n=10), group2 (MID<533.33 mg/d, n=10).The C_min of teicoplanin was measured by HPLC.RESULTS: The C_min of teicoplanin was closely related to initial dose, Pearson correlation was 0.685 and the correlation was significant at the 0.01 level (2-tailed). The C_min and the therapeutic effect of patients who were accepted the initial load dose of teicoplanin was higher and better than the patients who weren't accepted the initial load dose (P<0.01).There was no statistically difference in two groups with the frequency of side-effect.CONCLUSION: The findings suggest that a regular initial load dose of teicoplanin make it possible to rapidly attain an optimal trough concentration and acquire a good therapeutic effect.It is necessary for ICU patient who is treated with teicoplanin to regulate dose by the result of TDM to avoid the side-effect.

Key words: Antibiotic, Teicoplanin, Therapeutic drug monitoring, Load dose

CLC Number:

LI Hao, WANG Xue, DONG Hai-yan, DONG Ya-lin, TIAN Gang. Clinical analysis of therapeutic drug monitoring and drug dosage for ICU patients treated with teicoplanin[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(5): 538-544.

References

[1] Soy D, López E, Ribas J. Teicoplanin population pharmacokinetic analysis in hospitalized patients [J]. Ther Drug Monit, 2006, 28(6): 737-743.
[2] MacGrowan AP. Pharmacodynamics, pharmacokinetics and therapeutic drug monitoring of glycopeptides [J]. Ther Drug Monit, 1998, 20(5): 473-477.
[3] Matsumoto K, Kanazawa N, Ikawa K, et al. Determination of teicoplanin trough concentration target and appropriate total dose during the first 3 ds: a retrospective study in patients with MRSA infections [J]. J Infect Chemother, 2010, 16(3):193-199.
[4] Sato M, Chida K, Suda T, et al. Recommended initial loading dose of teicoplanin, established by therapeutic drug monitoring, and outcome in terms of optimal trough level [J].J Infect Chemother, 2006, 12(4): 185-189.
[5] Harding I, MacGowan AP, White LO, et al. Teicoplanin therapy for staphylococcus aureus septicaemia: relationship between pre-dose serum concentrations and outcome [J]. J Antimicrob Chemother , 2000, 45(6): 835-841.
[6] Pea F, Brollo L,Viale P, et al. Teicoplanin therapeutic drug monitoring in critically ill patients: a retrospective study emphasizing the importance of a loading dose [J]. J Antimicrob Chemother, 2003, 51(4): 971-975.
[7] Jie S, Zheng J, Zhou YN,et al. Quantification of teicoplanin in human plasma by liquid chromatography with ultraviolet detection [J]. Chromatographia, 2006, 10(65): 1365.
[8] Nevile LO, Balliod R, Grady D, et al. Teicoplanin in patients with chronic renal failure on dialysis: microbiological and pharmacokinetic aspects [J]. Int J Clin Pharmacol Res, 1987, 7(6): 485-490.
[9] Meyer B, Traunmüller F, Hamwi A, et al. Pharmacokinetics of teicoplanin during continuous hemofiltration with a new and a 24-h used highly permeable membrane: rationale for therapeutic drug monitoring-guided dosage [J]. Int J Clin Pharmacol Ther, 2004, 42(10): 556-560.
[10] Kroh UF, Dinges GK, Lukasewitz P, et al. Elimination of drugs by the new polyamide -hemofilter FH77H during various in vitro conditions [J]. Blood Purif, 1998, 16(1): 49-56.
[11] 华俊彦,田伟强,朱雅艳,等. 万古霉素治疗耐药甲氧西林金黄色葡萄球菌的疗效和血药浓度 [J].中国临床药理学与治疗学,2010, 15(6): 673-677.
[12] Niwa T, Imanishi Y, Ohmori T, et al. Significance of individual adjustment of initial loading dosage of teicoplanin based on population pharmacokinetics [J]. Int J Antimicrob Agents, 2010, 35(5): 507-510.
[13] Pauluzzi S, Del Favero A, Menichetti F, et al. Treatment of infections by staphylococci and other gram-positive bacteria with teicoplanin: an open study [J]. J Antimicrob Chemother, 1987, 20(3): 431-438.
[14] Alfandari S, Levent T, Descamps D, et al. Evaluation of glycopeptide use in nine French hospitals [J]. Med Mal Infect, 2010, 40(4): 232-237.

[1]	WU Lili, LIANG Zhi, HUANG Siyong, WANG Yan. Effect of augmented renal clearance (ARC) on the pharmacokinetics, efficacy, and safety of vancomycin in patients with infective endocarditis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(10): 1139-1145.
[2]	XU Tao, ZHU Suyan, QIU Xiangjun, XU Ping. Population pharmacokinetics of teicoplanin in patients with renal insufficiency [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(9): 977-983.
[3]	HE Jie, LIU Dongxue, ZHONG Lingjun, SHAO Hua, HU Linlin. Establishment of a limited sampling strategy to estimate micafungin exposure in critically ill patients [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(11): 1264-1271.
[4]	PENG Min, HUANG Panhao, DENG Yinhua, LIU Wen, LI Wei, YU Zhen, XIA Qing, XIE Yueliang. Analysis of influence factors of voriconazole trough concentration in patients with hematopoietic stem cell transplantation [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(6): 640-646.
[5]	ZHANG Siliang, HU Linlin, SHAO Hua, CHEN Xijing. Research progress on the influence of sex differences on the action of psychotropic drugs#br# [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(3): 324-331.
[6]	ZHANG Lu, LIN Liangmo, LIU Keke, HUANG Yamin, HUANG Xingxing, YANG Yongyu, XIAO Jian. Therapeutic drug monitoring and pharmacokinetics of new coronavirus pneumonia antiviral drugs [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(5): 566-575.
[7]	YANG Jingmo, ZHANG Bo, SUN Yancai. Review and economic analysis of preoperative antimicrobial application during the period of type I incision operation in a cancer hospital [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(7): 821-825.
[8]	HUA Xudan, XIE Hongyi, YU Shufang. Analysis of the efficacy, safety and economics of prophylactic antibiotics in high-risk neonates guided by C reaction protein and procalcitonin [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(5): 561-566.
[9]	DING Zhirong, CAI Xiaozhen, ZENG Haiwen, LIN Tianlai. Population pharmacokinetics of vancomycin in post-operative neurosurgical patients [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(11): 1252-1257.
[10]	ZHANG Chao . Pharmacodynamic studies evaluation of voriconazole [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(1): 116-120.
[11]	LI Chun-xing, FU Qiang, ZHU Zhu. The tissue penetration and pharmacodynamics of linezolid in the infected tissues [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2015, 20(3): 349-355.
[12]	SHANG Li-na, HONG Ming-yue. Recent progresses on antibody-targeted conjugates of antitumor antibiotics [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(9): 1075-1080.
[13]	ZHAN Ying, SHU Nan, GUO Nan, SHAO Hua, LI Wei-lan. Advances in therapeutic drug monitoring for triazole antifungal agents [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 706-711.
[14]	LI Yuan-yuan, YU Feng, GE Wei-hong. Epidemiology and analysis on the correlation between resistance of pathogenic bacteria and the intensity of piperacillin-tazobactam apllication in intensive care unit from 2008 to 2012 [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(5): 561-566.
[15]	ZHANG Xiao-fen, YANG Sai-cheng, WANG Bin-hui, WANG Shi-jian, WANG Jin-ming. Analysis on prophylactic antibiotics use in three kinds of type I incision operation [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(8): 924-927.