Teicoplanin

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Loading dose: 400 mg every 12 hours for 3 doses, thenIM/IV: 200–400 mg daily, or 3–6 mg/kg/day (up to 10 mg/kg/day in some reports) in life threatening infections

PHARMACOKINETICS

Molecular weight :1875–1891

%Protein binding :90–95

%Excreted unchanged in urine : >97

Volume of distribution (L/kg) :0.94–1.4

half-life – normal/ESRD (hrs) :150/62–230

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Give normal loading dose, then dose as in normal renal function

10 to 20 : Give normal loading dose, then 200–400 mg every 24–48 hours

<10 : Give normal loading dose, then 200–400 mg every 48–72 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Dialysed.1 Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

Use water for injection provided

Route

IV, IM

Rate of Administration

IV bolus: 2–3 minutes;

IV infusion

: 30 minutes

Comments

USE IN

CAPD : Give 400 mg IV stat dose, then 20 mg/L/ bag IP for 7 days, then 20 mg/L/alternate-bag for 7 days, then 20 mg/L/night-bag only for 7 days

OTHER INFORMATION

TDM optimises therapy, but not essential. Troughs not less than 10 mg/L. Peaks 1 hour after:

20 to 50 : mg/LRelationship between blood level and toxicity not establishedLong-term concurrent use of gentamicin and teicoplanin causes additive ototoxicity

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