Official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. The information on dosage adjustments in renal impairment given in this book is based on. Teicoplanin has an exceptionally long halflife, allowing. Johns hopkins guide app for ios, iphone, ipad, and android included. Targocid 400mg summary of product characteristics smpc. Introduction drug utilization evaluation due studies are designed to evaluate appropriate drug usage. Welcome to the fifth edition of the renal drug handbook. Do not use egfr estimates available on pas for drug dosing purposes see 2006 article from hospital pharmacist. This medication is given when other antibiotics fail to fully eliminate the bacteria or in cases when other patients are allergic to other antibiotics. Therefore, teicoplanin can be used in cases of osteomyelitis, septic arthritis and septicaemia. Comparing the effect of teicoplanin and vancomycin. Teicoplanin and vancomycin are two commonly used treatments forgrampositive bacterial infections, especially methicillinresistant staphylococcusaureus mrsa60, 61. Dosing guidelines for varying degrees of renal impairment are stated accordingly. Evaluation of teicoplanin dosing designs to achieve a new.
Data protection act 2018 general data protection regulation gdpr legislation. Data sources include ibm watson micromedex updated 28 feb 2020, cerner multum updated 2 mar. An initial loading procedure has been recommended for teicoplanin to enable prompt reaching of the optimal serum trough level 1015 microgml. Teicoplanin pharmacokinetics in patients with chronic. For oncedaily dosing, draw a single random level 8 to 12 hours after dose given adjustments are made based on a published hartford nomogram. Teicoplanin is an antibiotic that is used for the treatment of bacterial infections which sometimes occurs in the blood or joint or bone.
Carbapenems, linezolid, teicoplanin utilization evaluation. However, the dose of teicoplanin that should be administered to patients with varying renal function levels remains inconclusive. This guideline may be varied, withdrawn or replaced at any time. To provide guidance to rcht staff on the prescribing and therapeutic drug monitoring for teicoplanin therapy. Teicoplanin is a glycopeptide antibiotic active against grampositive bacteria only. When patients are being treated with antibiotics such as this, it is important that levels are monitored to ensure that they are not so high that they are toxic or so low that they are ineffectual. Teicoplanin 704 telbivudine 705 telithromycin 706 telmisartan 707 temazepam 708 temocillin 709. Access monograph information through desktop, laptop or mobile devices, with this new, easytouse, frequentlyupdated online platform. Evaluation of teicoplanin dosing designs to achieve a new target trough concentration article in journal of infection and chemotherapy 183. A catalogue record for this book is available from the british library. Teicoplanin levels may take 7 to 10 days to be reported. The disposition of teicoplanin was adequately described by a threecompartment open pharmacokinetic model and it appears to be primarily related to the degree of renal function. Dosing recommendations are based on creatinine clearance calculated using the cockcroftgault equation.
Valganciclovir, valproic acid, vancomycin, vasopressin, vecuronium. The oral dose recommendation for teicoplanin is 100400 mg by mouth every 12 hours for 10 days. The pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. The renal drug handbook the st georges hospital, adult critical.
Its mechanism of action is to inhibit bacterial cell wall synthesis. Teicoplanin is a glycopeptide antibiotic with a molecular structure which is related to that of vancomycin. Adjust maintenance dose based on teicoplanin level or renal function. Teicoplanin is nephrotoxic in animals, although at much higher doses than those used in humans. Munar, pharmd, bcps, and harleen singh, pharmd oregon state university college of. Teicoplanin was assayed in plasma and urine specimens by a. Stavudine, streptomycin, tacrolimus, teicoplanin, terbutaline, thioguanine.
Antibiotics may be metabolized in the liver often into inactive metabolites or they may be excreted unchanged in the urine or bile hepatic metabolismexcretion is generally convenient, because this means the drug dose doesnt need to be adjusted based on renal function. Creatinine clearance between 40 and 60 ml per minute. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. The recommendations below should be used as a guideto aid in antibiotic dosing while on crrt. For hd, draw trough prehd, and peak 30 min after end of each infusion streptococci, streptococcus bovis, strep. It is used to kill bacteria responsible for infections which can occur in your blood, bones or joints. Dosing regime above aims to achieve a trough of 2030mgl. Dosing is individualised based on weight and renal function to achieve target predose trough levels. Renal dosage adjustment guidelines for antimicrobials the. Teicoplanin is an antibiotic used in the prophylaxis and treatment of serious infections caused by grampositive bacteria, including methicillinresistant staphylococcus aureus and enterococcus faecalis. When patients are being treated with antibiotics such as this, it is important that levels are monitored to. Teicoplanin prescribing and therapeutic drug monitoring clinical guideline v2. Trough level is outwith the recommended range of 1520mgl.
Renal dose adjustment guidelines for antimicrobials. Teicoplanin versus vancomycin for proven or suspected. Drug route dose adjustment for renal impairment gfr in mlmin peritoneal dialysis pd intermittent haemodialysis ihd. Teicoplanin is a topic covered in the johns hopkins abx guide. If the pharmacy thats willing to deliver medicines to your home doesnt have teicoplanin in stock, you can ask for one of the branded alternatives for teicoplanin. Dosing regimens should be tailored based on presumed source of infection, mic data when available, and residual renal function. Medical information for teicoplanin on pediatric oncall including mechanism, indication, contraindications, dosing, adverse effect, interaction. Teicoplanin is a generic medicine name and there are several brands available for it. Teicoplanin is added to the dialysis solution at a concentration of 20 mgl.
For renally excreted drugs with a narrow therapeutic index, the total daily maintenance dose may be reduced either by decreasing the dose or by increasing the dosing interval, or sometimes by a combination of both. It is a semisynthetic glycopeptide antibiotic with a spectrum of activity similar to vancomycin. Due to its long halflife, teicoplanin requires the administration of loading doses to achieve satisfactory serum levels. Renal drug handbook 3rd edition general intensive care unit. The relative behavior of the six major components was only slightly affected by renal failure. Teicoplanin complete drug information, side effects and. There is uncertainty regarding the effects of teicoplanin compared to vancomycin on kidney function with some previous studies suggesting teicoplanin is less nephrotoxic than vancomycin. There is an uncertainty about the effects ofteicoplanin compared with vancomycin in their effectiveness on renal function. Teicoplanin definition of teicoplanin by medical dictionary. Teicoplanin uses, side effects, substitutes, composition. Teicoplanin is a topic covered in the johns hopkins abx guide to view the entire topic, please sign in or purchase a subscription official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine.
To investigate the efficacy and safety of vancomycin versus teicoplanin in patients with proven or suspected infection. When a patient is initiated on crrt, antimicrobial therapy often requires adjustment to ensure adequate drug concentrations are achieved. Renal dosage adjustment guidelines for antimicrobials. The renal drug handbook is now available in database format. Some of the brands for teicoplanin might be better known than teicoplanin itself. Teicoplanin dosing recommendation for the harmonisation of spcs regarding dosing ec decision september 20 the dose and duration of treatment should be adjusted according to the underlying type and severity of infection and clinical response of the patient, and patient factors such as age and renal function.
Teicoplanin inpatient dosing guidelines age 16 and over. Drug dosing adjustments in patients with chronic kidney. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Grampositive bacteria such as staphylococci including methicillinresistant strains, streptococci, enterococci and many anaerobic grampositive bacteria are susceptible to teicoplanin in vitro. The total and renal clearances of teicoplanin depends on the creatinine clearance. Renal dose adjustment guidelines for antimicrobials crrt. Drug dosing adjustments in patients with chronic kidney disease myrna y. These genes confer high to moderate level resistance to vancomycin and teicoplanin. Teicoplanin has been approved for the treatment of serious staphylococcal or streptococcal infections which cannot be treated satisfactorily with less toxic antibiotics. Cvvhd removes solutes including drugs via diffusion. Teicoplanin prescribing and therapeutic drug monitoring.
Antimicrobial agents antibacterial antibiotics antifungal antibiotics antimycobacterial antibiotics antiparasitic antibiotics antiviral agents. Teicoplanin mechanism, indication, contraindications. Teicoplanin drug information indications, dosage, side. To view the entire topic, please or purchase a subscription. While not in all patients, therapeutic drug monitoring may be of value in severe sepsis, mrsa infection, deepseated staphylococcal infection, bone and joint infection, iv drug misusers, infective endocarditis, unexpected therapeutic failure, and elderly or renally impaired patients.
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