Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2023 Feb 20;38(7):e62. doi: 10.3346/jkms.2023.38.e62.
Teicoplanin is a glycopeptide antimicrobial that treats serious invasive infections caused by gram-positive bacteria, such as the methicillin-resistant . Despite some comparable advantages, there is no guideline or clinical recommendation for teicoplanin in the pediatric population, unlike vancomycin where abundant studies and the recently revised guideline on therapeutic drug level monitoring (TDM) exist.
The systematic review was performed in accordance with the preferred reporting items for systematic reviews. Two authors (JSC and SHY) searched PubMed, Embase, and Cochrane Library databases using relevant terms independently.
Fourteen studies were finally included with a total of 1,380 patients. TDM was available in 2,739 samples collected in the nine studies. Dosing regimens varied widely, and eight studies used recommended dosing regimens. Timing for measuring TDM was mostly 72-96 hours or longer after the initiation of the first dose, which was expected to be a steady-state. The majority of studies had target trough levels of 10 µg/mL or above. Three studies reported that the clinical efficacy and treatment success rate of teicoplanin was 71.4%, 87.5%, and 88%. Adverse events associated with teicoplanin use were described in six studies with a focus on renal and/or hepatic impairment. Except for one study, no significant relation was noted between the incidence of adverse events and trough concentration.
Current evidence on teicoplanin trough levels in pediatric populations is insufficient due to heterogeneity. However, target trough levels with favorable clinical efficacy are achievable by recommended dosing regimen in the majority of patients.
替考拉宁是一种糖肽类抗菌药物，用于治疗由革兰氏阳性菌引起的严重侵袭性感染，如耐甲氧西林金黄色葡萄球菌。尽管替考拉宁具有一些类似的优势，但与万古霉素不同，儿科人群中没有替考拉宁的指南或临床推荐，而万古霉素有大量的研究和最近修订的治疗药物监测（TDM）指南。
系统评价按照系统评价的首选报告项目进行。两位作者（JSC 和 SHY）独立使用相关术语在 PubMed、Embase 和 Cochrane Library 数据库中进行搜索。
最终纳入了 14 项研究，共 1380 名患者。在 9 项研究中，有 2739 份样本进行了 TDM。给药方案差异很大，8 项研究使用了推荐的给药方案。测量 TDM 的时间大多在首次给药后 72-96 小时或更长时间，这是预期的稳态时间。大多数研究的目标谷浓度为 10µg/mL 或以上。有 3 项研究报告替考拉宁的临床疗效和治疗成功率分别为 71.4%、87.5%和 88%。有 6 项研究描述了与替考拉宁使用相关的不良事件，主要是肾和/或肝损伤。除了一项研究外，不良事件的发生率与谷浓度之间没有显著关系。
由于异质性，目前关于儿科人群中替考拉宁谷浓度的证据不足。然而，在大多数患者中，通过推荐的给药方案可以达到目标谷浓度和良好的临床疗效。
