Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Hofer, N.
The Role of Age and Sex on Teicoplanin Serum Levels in Children and Adults - Analysis of Teicoplanin Therapeutic Drug Monitoring
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2015. pp.111.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Pansy Jasmin
- Strenger Volker
- Zollner-Schwetz Ines
- Altmetrics:
- Abstract:
- Background. The aim of the study was to evaluate teicoplanin levels in real-life setting in a large cohort of paediatric and adult patients with special respect to sex- and age-related differences. Methods. At our hospital, different dosing recommendations comprise dosages ranging from 6 to 15 mg/kg per once daily single dose. Most recommendations include an additional second dose within the first 24 h ("loading dose"). Initial TTLs are analysed on treatment day 3 or 4 and dosing is adapted according to trough teicoplanin levels (TTLs) to achieve levels in the target range >10 µg/mL, >20 µg/mL for severe infections. In a retrospective analysis we evaluated 4413 TTLs obtained during 1380 treatment episodes from 2005 to 2014. Results. Initial TTLs were <10µg/mL in 32.2% and <20µg/mL in 73.3% of patients. Adults (15.0-64.9 years) and elderly patients (=65 years) had significantly lower TTLs when compared to children (0-14.9 years) and a consecutively 3.7- and 3.5-fold increased risk of having levels <10µg/mL (41.3% and 40.0% vs. 15.9%, respectively, p<0.001, each). For the entire cohort, follow-up TTLs were less likely to be <10 µg/mL (13.2%) and <20µg/mL (58.7%) when compared to initial TTLs (p<0.001, each). Initial and follow up TTL courses were different in females and males (initial: p<0.001; follow up: p=0.013). In adults, males were at an increased risk for having initial TTLs <10 (p<0.001). There were no sex-related differences in children. Conclusion. Teicoplanin pharmacokinetics depends on age and sex with higher levels in younger patients and females. A significant proportion of patients, especially adults, has initial TTLs below the target range; thus, more tailored dosing regimens with higher loading doses should be considered in these patient groups. Therapeutic drug monitoring is mandatory to achieve therapeutic concentrations.