Vol.63 No.1 January 2015
Four times loading dose of teicoplanin achieves an effective serum concentration in pediatric cases
Department of Pharmacy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Japan
Abstract
The initial loading dose of teicoplanin (TEIC) to achieve an effective serum concentration has been recommended. However, only a few studies have examined this loading dose in pediatric cases. In the present study, we retrospectively investigated the relationship between the initial TEIC dosage and the trough serum concentration or safety in pediatric in-patients at Hiroshima University Hospital from 2008 to 2013. We examined 24 patients under 15 years of age who received 3 or 4 doses of TEIC during the first two days and in whom the TEIC dose did not change until the first assessment of the trough concentration of TEIC on the fourth and fifth day. The proportion of patients who achieved an initial TEIC trough concentration of ≥10 μg/mL was significantly different between the patients who received 3 and 4 loading does (37.5% vs 87.5%, p=0.027). However, the difference of that of ≥15 μg/mL was not significant (31.3% vs 37.5%, p=0.779). In the safety analysis, hepatic side effects were observed frequently in both the groups, although no significant difference was noted between the groups; no renal side effects were observed in either group. The TEIC trough concentration was not correlated with the TEIC dose or laboratory data (ALB, the serum Cr level or estimated glomerular filtration rate). In the present study, we showed that the standard TEIC dosing regimen (three doses of 10 mg/kg every 12 h) was not sufficient to achieve an effective serum concentration. The administration of 4 loading doses appeared to be appropriate to achieve an effective serum concentration. However, additional studies are required to clarify the dosing regimen needed to achieve a concentration of 15 μg/mL for more effective treatment.
Key word
teicoplanin, pediatric, therapeutic drug monitoring, loading dose
Received
April 18, 2014
Accepted
December 1, 2014
Jpn. J. Chemother. 63 (1): 7-10, 2015
