Pharmacokinetics of teicoplanin in critically ill patients with various degrees of renal impairment

Domart, Y.; Pierre, C; Clair, Bernard; Garaud, Jean–Jacques; Régnier, B.

doi:10.1128/aac.31.10.1600

Cited by 23 publications

(12 citation statements)

References 11 publications

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“…For agents such as teicoplanin which have markedly prolonged halflives and are administered on a once-daily basis, the trough concentration in serum may be more important than the 1-h peak level in predicting therapeutic efficacy (7). Frequent monitoring of concentrations in serum during therapy of serious infections appears warranted, particularly since considerable variability was noted in the pharmacokinetic parameters for both teicoplanin and vancomycin among the individual patients (4,10,15). The bioassay we have described is particularly suited for this purpose in the clinical laboratory.…”

Section: Methodsmentioning

confidence: 99%

Application of a modified bioassay for monitoring serum teicoplanin and vancomycin in febrile neutropenic patients

Kureishi

Jewesson

Bartlett

et al. 1990

Antimicrob Agents Chemother

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Teicoplanin is a glycopeptide antibiotic with a mode of action and spectrum of activity similar to those of vancomycin. Its efficacy and tolerability as empiric therapy and its pharmacokinetic properties in neutropenic patients are being studied in a double-blinded, randomized trial in comparison with those of vancomycin. We report here a modified agar diffusion bioassay which is suitable for monitoring levels of either teicoplanin or vancomycin in serum during combination therapy with ,-lactams, aminoglycosides, and amphotericin B. Serum samples spiked with either teicoplanin or vancomycin gave reproducible results (mean coefficient of variation, 8.8%) regardless of the presence of tobramycin, amikacin, piperacillin, ceftazidime, amphotericin B, or their combinations. Among 25 patients who received teicoplanin at a dosing schedule of 6 mg/kg every 24 h intravenously, steady state was reached after 14.2 ± 4.0 days, and 1-h peak and trough concentrations of teicoplanin in serum at steady state were 40.8 ± 15.0 and 12.5 ± 3.2 mg/liter, respectively. In contrast, among 25 patients who received vancomycin at a dosing schedule of 15 mg/kg every 12 h intravenously, steady state was reached by 24 h, and the 1-h peak and trough concentrations in serum were 37.5 ± 15.6 and 8.3 ± 3.8 mg/liter, respectively. The elimination half-lives for teicoplanin estimated by two separate approaches agreed closely with each other: 80.5 ± 21.5 h by an accumulation model (M. Gilbaldi and D. Perrier, Pharmacokinetics, 2nd ed., p. 121, 1982) and 87.3 ± 19.3 h as predicted from the degree of renal function (M. Rowland, Clin. Pharmacokinet. 18:184-209, 1990). These values were 14-to 15-fold higher than that for vancomycin (5.61.8 h). Since considerable variability was noted in the pharmacokinetic parameters for both teicoplanin and vancomycin among the individual patients, our data further emphasized the need for frequent monitoring of these drugs during empiric therapy of the febrile neutropenic patient.

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Section: Methodsmentioning

confidence: 99%

Application of a modified bioassay for monitoring serum teicoplanin and vancomycin in febrile neutropenic patients

Kureishi

Jewesson

Bartlett

et al. 1990

Antimicrob Agents Chemother

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“…597,1989). Moreover, its pharmacokinetic properties allow for single-daily-dose therapy (5,6). If used as a prophylactic agent in cardiac surgery, it might be a practical alternative to standard antibiotics, including cefazolin, cefamandole, semisynthetic penicillins given alone or in combination with aminoglycosides, or vancomycin, which is occasionally used when methicillin-resistant staphylococcal contamination is a concern.…”

mentioning

confidence: 99%

Concentrations of teicoplanin in serum and atrial appendages of patients undergoing cardiac surgery

Bergeron

Saginur

Desaulniers

et al. 1990

Antimicrob Agents Chemother

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The concentrations of teicoplanin in sera and heart tissues of 49 patients undergoing coronary bypass were measured. Each patient received a 6-or 12-mg/kg dose of teicoplanin administered in a slow intravenous bolus injection over 3 to 5 min beginning at the time of induction of anesthesia. Mean ± standard error of the mean concentrations in serum were, for the two doses, respectively, 58.1 ± 1.7 and 123.3 ± 7.4 ,g/ml 5 min after administration and 22.2 ± 0.7 and 56.5 ± 2.8 pg/mi at the time of removal of atrial appendages. Mean ± standard error of the mean concentrations in tissue were 70.6 ± 1.7 and 139.8 ± 2.2 ,g/g, respectively, giving mean tissue/serum ratios of 3.7 ± 0.3 and 2.8 ± 0.2, respectively. Teicoplanin penetrates heart tissue readily and reaches levels in the serum far in excess of the MICs for most pathogens that have been found to cause infections following open heart surgery.The incidence of infection following cardiac surgery caused by multiresistant Staphylococcus aureus, Staphylococcus epidermidis, and group JK diphtheroids is increasing (12,15,16). Thus far, vancomycin has been a valid alternative to standard antibiotic prophylaxis; but complications may occur if it is administered by rapid injection, and major side effects have restricted its use. Teicoplanin, a new glycopeptide antibiotic that is chemically related to the vancomycin-ristocetin group, has in vitro activity similar to that of vancomycin and seems to be less toxic (4, 7, 10, , abstr. no. 597, 1989). Moreover, its pharmacokinetic properties allow for single-daily-dose therapy (5, 6). If used as a prophylactic agent in cardiac surgery, it might be a practical alternative to standard antibiotics, including cefazolin, cefamandole, semisynthetic penicillins given alone or in combination with aminoglycosides, or vancomycin, which is occasionally used when methicillin-resistant staphylococcal contamination is a concern. In the present study, we evaluated the penetration of teicoplanin into the heart tissues of patients undergoing cardiopulmonary bypass surgery. MATERIALS AND METHODSA total of 32 patients (16 from Quebec, Quebec, Canada, and 16 from Ottawa, Ontario, Canada) who were about to undergo cardiopulmonary bypass surgery were studied initially. They all gave written informed consent to take part in the study. They received a 6-mg/kg dose of teicoplanin administered in a slow bolus injection over 3 to 5 min through a peripheral vein beginning at the time of induction of anesthesia. Following this initial study, a second group of 17 patients operated on in Quebec City were studied and were given a 12-mg/kg dose that was administered in a similar fashion. All the assays and analysis of data were done * Corresponding author.at the Infectious Disease Research Laboratory, Centre Hospitalier de l'Universitd Laval, Quebec City. The group that received the 6-mg/kg dose was composed of 24 males and 8 females, and the group that received the 12-mg/kg dose was composed of 16 males and 1 female. The ages of the two groups of patient...

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“…In most infections, the treatment duration with fluoroquinolones is short, but tuberculosis (TB) 308 patients are treated for a long period of time [41]. Especially in multidrug-resistant tuberculosis and 309 in cystic fibrosis patients or patients treated for hospital acquired pneumonia, TDM can be 310 important [32,38,41,42]. DBS can be of great advantage in these situations because these patients 311 can be treated at home.…”

Section: Fluoroquinolones 300mentioning

confidence: 99%

“…Ciprofloxacin is used in more common 301 infections, while moxifloxacin is used for infections caused by less common or resistant pathogens, 302 for example Mycobacterium tuberculosis. Most fluoroquinolones need dose adjustments in patients 303 with decreased renal function [25,[37][38][39]. These drugs are not extensively metabolised in the liver, 304 so no dose adjustments are required for patients with impaired liver function [37,40].…”

Section: Fluoroquinolones 300mentioning

confidence: 99%

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Role of Therapeutic Drug Monitoring in Pulmonary Infections: Use and Potential for Expanded Use of Dried Blood Spot Samples

et al. 2015

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Respiratory tract infections are among the most common infections in men. We reviewed literature to document their pharmacological treatments, and the extent to which therapeutic drug monitoring (TDM) is needed during treatment. We subsequently examined potential use of dried blood spots as sample procedure for TDM. TDM was found to be an important component of clinical care for many (but not all) pulmonary infections. For gentamicin, linezolid, voriconazole and posaconazole dried blood spot methods and their use in TDM were already evident in literature. For glycopeptides, beta-lactam antibiotics and fluoroquinolones it was determined that development of a dried blood spot (DBS) method could be useful. This review identifies specific antibiotics for which development of DBS methods could support the optimization of treatment of pulmonary infections

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Pharmacokinetics of teicoplanin in critically ill patients with various degrees of renal impairment

Cited by 23 publications

References 11 publications

Application of a modified bioassay for monitoring serum teicoplanin and vancomycin in febrile neutropenic patients

Application of a modified bioassay for monitoring serum teicoplanin and vancomycin in febrile neutropenic patients

Concentrations of teicoplanin in serum and atrial appendages of patients undergoing cardiac surgery

Role of Therapeutic Drug Monitoring in Pulmonary Infections: Use and Potential for Expanded Use of Dried Blood Spot Samples

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