Vol.56 No.4 July 2008
Therapeutic drug monitoring of teicoplanin in infectional endocarditis caused by Corynebacterium jeikeium
1)Department of Pharmacy, Niitsu Medical Center Hospital, 610 Koda, Akiha-ku, Niigata, Japan
2)Department of Respiratory and Infectious Disease, Niigata City General Hospital
Abstract
We report a case in which teicoplanin(TEIC) was administered to a man aged 79 years who had infectious endocarditis caused by Corynebacterium jeikeium 100 days after aortic valve replacement after drug sensitivity was verified. The blood trough concentration was measured and analyzed with TEIC analysis software and the administered dose adjusted as needed. Although loading was done 3 times at the beginning, reloading was necessary on 4 days after drug was administered because drug concentration in blood takes time. The trough reached the target value of 17 μg/mL, but CRP was elevated and fever developed. Reloading was repeated changing the target, leading to a final adjustment of 23-24 μg/mL. Vegitation disappeared after 6 months of administration, and no adverse events were seen. Compared to cases of autologous infection, those with infective endocarditis after prosthetic valve replacement often result in a poor prognosis, this case was an example in which TEIC was administrated effectively with TDM.
Key word
infectious endocarditis, teicoplanin, therapeutic drug monitoring, Corynebacterium jeikeium
Received
January 16, 2008
Accepted
May 1, 2008
Jpn. J. Chemother. 56 (4): 475-478, 2008
