Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Strenger, V; Hofer, N; Rödl, S; Hönigl, M; Raggam, R; Seidel, MG; Dornbusch, HJ; Sperl, D; Lackner, H; Schwinger, W; Sovinz, P; Benesch, M; Urlesberger, B; Urban, C.
Age- and gender-related differences in teicoplanin levels in paediatric patients.
J Antimicrob Chemother. 2013; 68(10):2318-2323
Doi: 10.1093/jac/dkt176
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- Führende Autor*innen der Med Uni Graz
- Hofer Nora
- Strenger Volker
- Co-Autor*innen der Med Uni Graz
- Benesch Martin
- Dornbusch Hans Jürgen
- Hönigl Martin
- Lackner Herwig
- Raggam Reinhard Bernd
- Ritter-Sovinz Petra
- Roedl Siegfried
- Schwinger Wolfgang
- Seidel Markus
- Sperl Daniela Ingrid
- Urban Ernst-Christian
- Urlesberger Berndt
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- Abstract:
- Objectives: Teicoplanin is a glycopeptide antibiotic active against Gram-positive bacteria, including methicillin-resistant staphylococci. While teicoplanin trough levels (TTLs) >10 mg/L are commonly considered appropriate, levels >20 mg/L are aimed for in the treatment of severe infections. Due to toxicity, it is recommended to avoid levels >60 mg/L. Patients and methods: In our institution, the initial dosing schedule of teicoplanin (10-15 mg/kg every 12 h for three loading doses and every 24 h thereafter) is adapted according to TTLs analysed by a fluorescence polarization immunoassay on treatment days 2 to 4. Teicoplanin peak levels (TPLs) are analysed in selected cases 30 min after the end of infusion. In a retrospective analysis we evaluated 1357 TTLs and 333 TPLs from 410 treatment episodes from 2005 to 2011. Results: Initial TTLs were <10 mg/L in 14.1% and <20 mg/L in 72.6% of episodes. Toddlers had significantly lower TTLs, with a 2-fold and 2.5-fold increased risk of having levels <10 mg/L (24.6%) and <20 mg/L (82.6%), respectively. For the entire cohort, follow-up TTLs were less likely to be <10 mg/L and more likely to be >20 mg/L when compared with initial TTLs (P<0.001, each). Adolescent girls had significantly higher initial TPLs (P = 0.001) and significantly higher follow-up TTLs (P = 0.016) than adolescent boys. In parallel, adolescent girls had initial TPLs <60 mg/L significantly more frequently (P = 0.012) and follow-up TTLs <10 mg/L significantly less frequently (P = 0.005). Conclusions: More tailored dosing regimens with higher loading doses, especially for toddlers, should be considered. While further pharmacokinetic data in paediatric patients are pending, therapeutic drug monitoring is mandatory.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Age Factors -
- Anti-Bacterial Agents - administration & dosage
- Child -
- Child, Preschool -
- Female -
- Humans -
- Infant -
- Infant, Newborn -
- Male -
- Retrospective Studies -
- Sex Factors -
- Teicoplanin - administration & dosage
- Find related publications in this database (Keywords)
- glycopeptides
- pharmacokinetics
- therapeutic drug monitoring