Factors on trough teicoplanin levels, associations between levels, efficacy and safety in patients with gram-positive infections.

OBJECTIVE

The objective of this study was to identify the factors influencing trough teicoplanin concentrations (C(min)), to investigate the relationship between teicoplanin C(min) with efficacy and safety, and to determine a target therapeutic concentration.

METHODS

An analysis was performed on 95 serum concentrations from 50 patients with gram-positive infections who received teicoplanin treatment. Teicoplanin serum concentrations were measured by high-performance liquid chromatography. Univariate and multivariable analysis were performed to investigate the effect of independent variables on teicoplanin C(min). A logistic regression analysis was used to determine the relationship between teicoplanin C(min) and efficacy and safety.

RESULTS

Teicoplanin therapy was effective in 74.0% (37/50) of patients, and 10.0% (5/50) of patients exhibited signs of adverse events. Using multivariable linear regression, two covariates were found to be a significant effect on teicoplanin C(min): dosage (mg/kg), and creatinine clearance rate (CL(cr). There was no covariate that has a significant impact on the safety of teicoplanin and only teicoplanin C(min) has a significant impact on the efficacy of treatment in the logistics regression. The logistics regression analysis showed that teicoplanin C(min) of 10 mg/L was associated with a 79.4% probability of success response.

CONCLUSIONS

This study highlighted that teicoplanin C(min) was strongly influenced by the values of dosage (mg/kg) and CL(cr) and the teicoplanin C(min) range of 10 -€“ 20 mg/L was identified as the therapeutic target with optimum clinical efficacy and safety.