Vol.61 No.2 March 2013
Comparison between teicoplanin and vancomycin in the occurrence of adverse events in patients whose trough concentration was ≥20 μg/mL
1)Department of Pharmacy, Hyogo College of Medicine Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, Japan
2)Department of Infection Control and Prevention, Hyogo College of Medicine Hospital
Abstract
According to the UK guidlines, target trough concentrations of teicoplanin(TEIC) of ≥20 μg/mL are recommended for patients with complicated MRSA infections such as endocarditis, osteomyelitis and septic arthritis. However clinical assessment to support this target trough level of TEIC is insufficient. The objective of this study was to assess the lower risk of nephrotoxicity in patients whose TEIC trough concentration was ≥20 μg/mL compared with vancomycin(VCM). Patients younger than 18 years old and those undergoing dialysis were excluded. Between January 2009 and December 2010, 949 patients were treated with glycopeptide (VCM 589, TEIC 360), among whom 70 patients (11.9%) revealed trough concentrations of ≥20 μg/mL for VCM and 96 patients (26.7%) for TEIC. The incidences of nephrotoxicity in those patients were 32 (45.7%) and 11 (11.5%), respectively (p<0.001). Multivariate analyses revealed that TEIC administration significantly reduced the risk of nephrotoxicity (odds radio: 0.145, confidence interval: 0.062-0.342, p<0.001). In conclusion, the target trough concentration of ≥20 μg/mL was acceptable for TEIC from the safety analysis.
Key word
vancomycin, teicoplanin, nephrotoxicity, therapeutic drug monitoring（TDM）
Received
November 19, 2012
Accepted
January 23, 2013
Jpn. J. Chemother. 61 (2): 157-161, 2013
