Clinical efficacy and safety in patients treated with teicoplanin with a target trough concentration of 20 μg/mL using a regimen of 12 mg/kg for five doses within the initial 3 days

Autor: Kaoru Ichiki, Shingo Takubo, Hiroki Ikeuchi, Kumiko Yamada, Naruhito Otani, Yoshiko Takai, Kazuhiko Nakajima, Takashi Ueda, Mika Ishihara, Yoshio Takesue, Takeshi Kimura, Yoshiko Takahashi, Motoi Uchino, Toshie Tsuchida, Kaori Ishikawa
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Bacteremia
Therapeutic drug monitoring
Loading dose
Gastroenterology
Drug Administration Schedule
03 medical and health sciences
Cmin
0302 clinical medicine
lcsh:RA1190-1270
Internal medicine
medicine
Clinical endpoint
Humans
Pharmacology (medical)
Trough Concentration
030212 general & internal medicine
Adverse effect
Aged
Retrospective Studies
lcsh:Toxicology. Poisons
Pharmacology
Aged
80 and over
0303 health sciences
medicine.diagnostic_test
030306 microbiology
Teicoplanin
business.industry
lcsh:RM1-950
Middle Aged
Staphylococcal Infections
Anti-Bacterial Agents
Regimen
Treatment Outcome
lcsh:Therapeutics. Pharmacology
Trough concentration
Female
Drug Monitoring
business
Hypoalbuminemia
medicine.drug
Research Article
Zdroj: BMC Pharmacology and Toxicology, Vol 21, Iss 1, Pp 1-10 (2020)
BMC Pharmacology & Toxicology
ISSN: 2050-6511
DOI: 10.1186/s40360-020-00424-3
Popis: Background A trough concentration (Cmin) ≥20 μg/mL of teicoplanin is recommended for the treatment of serious methicillin-resistant Staphylococcus aureus (MRSA) infections. However, sufficient clinical evidence to support the efficacy of this target Cmin has not been obtained. Even though the recommended high Cmin of teicoplanin was associated with better clinical outcome, reaching the target concentration is challenging. Methods Pharmacokinetics and adverse events were evaluated in all eligible patients. For clinical efficacy, patients who had bacteremia/complicated MRSA infections were analyzed. The primary endpoint for clinical efficacy was an early clinical response at 72–96 h after the start of therapy. Five dosed of 12 mg/kg or 10 mg/kg was administered as an enhanced or conventional high loading dose regimen, respectively. The Cmin was obtained at 72 h after the first dose. Results Overall, 512 patients were eligible, and 76 patients were analyzed for treatment efficacy. The proportion of patients achieving the target Cmin range (20–40 μg/mL) by the enhanced regimen was significantly higher than for the conventional regimen (75.2% versus 41.0%, p min ≥ 20 μg/mL was an independent factor for an early clinical response (odds ratio 3.95, 95% confidence interval 1.25–12.53). There was no significant difference in the occurrence of adverse events between patients who did or did not achieve a Cmin ≥ 20 μg/mL. Conclusion A target Cmin ≥ 20 μg/mL might improve early clinical responses during the treatment of difficult MRSA infections using 12 mg/kg teicoplanin for five doses within the initial 3 days.
Databáze: OpenAIRE
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