Pharmacokinetics of teicoplanin in patients undergoing chronic haemodialysis

Papaioannou, Maria G.; Marinaki, Smaragda; Pappas, M.; Stamatiadis, Dimitrios; Giamarellos‐Bourboulis, Evangelos J.; Giamarellou, Helen; Stathakis, C

doi:10.1016/s0924-8579(02)00005-5

Cited by 16 publications

(6 citation statements)

References 12 publications

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“…Therapeutic drug levels at the infection site should be above 10 µg/mL (4). Although it has been considered that a dose of 6mg/kg might be safely administered intravenously in patients with moderate or severe renal failure (5), it has recently been proposed by our study group that the serum levels within the therapeutic range in anuric patients undergoing chronic hemodialysis may be achieved only after 10mg/kg dosing eac h 48or 72hours (6).…”

Section: Discussionmentioning

confidence: 90%

“…Concentrations of teicoplanin were measured in each sample by microbiological assay in Mueller-Hinton broth (Oxoid Ltd, London, UK), using Bacillus subtilis ATCC6633 as a reference strain. Determinations were made after plotting on semilogarithmic paper a standard curve created with known concentrations of teicoplanin (range 0.7 -200µg/mL), as performed by other authors (6,11). The intra-and interday coefficients of variation of the assay were 0.93 and 0.99 respectively (p< 0.0001).…”

Section: Determination Of Teicoplaninmentioning

confidence: 99%

“…For the treatment of infections caused by grampositive cocci, its trough serum levels should remain above 10 µg/mL (3,4). Although the proposed dosage regimen in anuric patients undergoing chronic hemodialysis is 6 mg/kg every 72 hours (5), it has been recently shown by our study group that, in order to achieve trough serum concentrations above 10 µg/mL, a dose of 10mg/kg eac h 48 hours should be administered intravenously (6).…”

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confidence: 94%

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Pharmacokinetics of Teicoplanin in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Stamatiadis

Papaioannou

Giamarellos‐Bourboulis

et al. 2003

Perit Dial Int

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Objective To achieve concentrations of teicoplanin in serum and dialysate within the therapeutic range in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Design Pharmacokinetic study. Setting A tertiary-care hospital. Patients Eight hospitalized anuric patients undergoing CAPD. Interventions One single dose of 10 mg/kg teicoplanin was administered intravenously, and blood and dialysate were sampled at regular time intervals for 48 hours post drug infusion. Concentrations of teicoplanin were determined by microbiological assay. Results Teicoplanin serum levels above 10 μg/mL, the level desired to treat systemic infections, were detected for 24 hours after administration. All dialysate concentrations were very low. Teicoplanin presented two phases of elimination: an early first phase and a late second phase. Mean maximum serum concentration was 75.56 μg/mL, mean half-life (t°) of the early elimination was 3.34 hours, mean t° of the late elimination was 61.68 hours, mean area under the serum-concentration–time curve was 1491.92 mg·hr/L, mean clearance rate was 10.68 mL/minute, mean apparent volume of distribution was 0.80 L/kg, and mean volume of distribution at steady state was 0.22 L/kg. Mean dialysate excretion was 3.16% and mean peritoneal clearance rate was 0.023 mL/minute. Conclusions Based on the time period with the achieved serum levels and on the prolonged t°, it is proposed that teicoplanin might be administered at 10 mg/kg every 24 hours for the therapy of systemic infections in patients undergoing CAPD. However, its intravenous administration should be avoided in the treatment of peritonitis, because the achieved dialysate concentrations were very low.

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Section: Discussionmentioning

confidence: 90%

Section: Determination Of Teicoplaninmentioning

confidence: 99%

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confidence: 94%

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Pharmacokinetics of Teicoplanin in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Stamatiadis

Papaioannou

Giamarellos‐Bourboulis

et al. 2003

Perit Dial Int

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“…Teicoplanin was not detected in the dialysate. Its concentrations in both the arterial and the venous lines of the fi stulae were similar (Papaioannou et al 2002 ). One single dose of 10 mg/kg teicoplanin was administered intravenously to eight anuric patients undergoing CAPD.…”

Section: Renal Impairmentmentioning

confidence: 86%

Glycopeptides

Gyssens

2013

Fundamentals of Antimicrobial Pharmacokinetics and Pharmacodynamics

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Glycopeptides are a class of antibiotic drugs that is composed of glycosylated cyclic or polycyclic nonribosomal peptides. Older molecules used in clinical practice are vancomycin and teicoplanin. Oritavancin, dalbavancin, and telavancin belong to the subclass of lipoglycopeptides. Glycopeptides inhibit bacterial cell wall peptoglycan synthesis of aerobic and anaerobic Gram-positive bacteria. Glyco (lipo)peptides are not absorbed orally and have to be administered intravenously. In this chapter, the pharmacokinetics (Pk) and the pharmacodynamics (Pd) of the glycopeptides are studied. Pk in serum as well as protein binding and elimination are reviewed. Pharmacodynamic data include MICs of Gram-positive bacteria, PK/Pd effects in in vitro systems, animal models and human studies. Adverse effects of glycopeptides on the host are concentration related nephro-and ototoxicity. In the past, because of fear of toxicity, the older glycopeptides have been underdosed in many settings. The implementation of Pk/Pd knowledge into clinical practice by e.g. administering higher doses of vancomycin and teicoplanin and using continuous infusion of vancomycin is urgently needed. This chapter contains clinical vignettes showing the benefi t of Therapeutic Drug Monitoring of glycopeptides.

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“…In hemodialysis patients, TEC requires a single weight-based loading dose of 6 mg/kg, given post dialysis in order to achieve the target level, or a loading dose of 400 mg. In this population, the maintenance dose should be one third of the normal dose (1 mg/kg) once a day, or normal unit dose every third day (200 mg; 3 mg/kg) (11). This data should be used in the standard dialysis treatment.…”

Section: Introductionmentioning

confidence: 99%