PMID- 31372903
OWN - NLM
STAT- MEDLINE
DCOM- 20200207
LR  - 20200207
IS  - 1435-4373 (Electronic)
IS  - 0934-9723 (Linking)
VI  - 38
IP  - 11
DP  - 2019 Nov
TI  - Evaluating the optimal dose of teicoplanin with therapeutic drug monitoring: not 
      too high for adverse event, not too low for treatment efficacy.
PG  - 2113-2120
LID - 10.1007/s10096-019-03652-6 [doi]
AB  - Therapeutic drug monitoring (TDM) of teicoplanin is aimed at minimizing the 
      clinical impact of pharmacokinetic variability; however, its benefits are still 
      being defined. We performed a retrospective study of teicoplanin TDM focusing on 
      the dose-serum concentration relationship and clinical outcomes in a clinical 
      setting. From January 2017 to December 2018, patients receiving teicoplanin 
      >/= 72 h with TDM were enrolled. Patients were divided into three groups: 
      non-loading (NL) group, low-dose loading (LD) group (loading dose < 9 mg/kg), and 
      high-dose loading (HD) group (>/= 9 mg/kg). Serum teicoplanin trough concentration 
      (C(min)) and adverse events (AEs) were evaluated in each regimen. A subgroup of 
      patients with bacteremia was analyzed to evaluate clinical efficacy. Among 65 
      patients, 12, 18, and 35 were grouped in NL, LD, and HD, respectively. 
      Achievement rates of C(min) > 20 mg/L within 10 days were significantly different 
      among the groups (25.0%, 38.9%, and 68.6% in the NL, LD, and HD groups, 
      respectively; P = 0.014). Fourteen patients (21.5%) had AEs, and higher C(min) 
      over 10 days (adjusted odds ratio 2.08 per every 20 mg/L increases, 95% CI 
      1.13-3.84, P = 0.019) and age >/= 65 years (P = 0.009) were identified as 
      independent risk factors. In the subgroup analysis, HD regimen (P = 0.050) and 
      high mean C(min) over 10 days (P = 0.025) were significantly associated with 
      treatment success. Although HL regimen could achieve C(min) targets and improve 
      clinical outcome during teicoplanin treatment, high C(min) was associated with 
      AEs during treatment. Routine TDM can be helpful to optimize teicoplanin 
      administration.
FAU - Kim, Si-Ho
AU  - Kim SH
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
FAU - Kang, Cheol-In
AU  - Kang CI
AUID- ORCID: 0000-0002-1741-4459
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. 
      collacin@hotmail.com.
FAU - Huh, Kyungmin
AU  - Huh K
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
FAU - Cho, Sun Young
AU  - Cho SY
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
FAU - Chung, Doo Ryeon
AU  - Chung DR
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
FAU - Lee, Soo-Youn
AU  - Lee SY
AD  - Department of Laboratory Medicine and Genetics, Samsung Medical Center, 
      Sungkyunkwan University School of Medicine, Seoul, South Korea.
FAU - Kim, Yae-Jean
AU  - Kim YJ
AD  - Division of Pediatric Infectious Diseases and Immunodeficiency, Department of 
      Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, South Korea.
FAU - Peck, Kyong Ran
AU  - Peck KR
AD  - Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
LA  - eng
GR  - 10080648/Ministry of Trade, Industry and Energy/
PT  - Journal Article
DEP - 20190801
PL  - Germany
TA  - Eur J Clin Microbiol Infect Dis
JT  - European journal of clinical microbiology & infectious diseases : official 
      publication of the European Society of Clinical Microbiology
JID - 8804297
RN  - 0 (Anti-Bacterial Agents)
RN  - 61036-62-2 (Teicoplanin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*administration & dosage/adverse effects/blood
MH  - Bacteremia/drug therapy
MH  - Dose-Response Relationship, Drug
MH  - *Drug Administration Schedule
MH  - *Drug Monitoring
MH  - Drug-Related Side Effects and Adverse Reactions/epidemiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Teicoplanin/*administration & dosage/adverse effects/blood
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adverse event
OT  - Bacteremia
OT  - Loading dose
OT  - Teicoplanin
OT  - Therapeutic drug monitoring
EDAT- 2019/08/03 06:00
MHDA- 2020/02/08 06:00
CRDT- 2019/08/03 06:00
PHST- 2019/06/04 00:00 [received]
PHST- 2019/07/17 00:00 [accepted]
PHST- 2019/08/03 06:00 [pubmed]
PHST- 2020/02/08 06:00 [medline]
PHST- 2019/08/03 06:00 [entrez]
AID - 10.1007/s10096-019-03652-6 [pii]
AID - 10.1007/s10096-019-03652-6 [doi]
PST - ppublish
SO  - Eur J Clin Microbiol Infect Dis. 2019 Nov;38(11):2113-2120. doi: 
      10.1007/s10096-019-03652-6. Epub 2019 Aug 1.