Teicoplanin Dosing Strategy for Treatment of Staphylococcus aureus in Korean Patients with Neutropenic Fever.
10.3349/ymj.2011.52.4.616
- Author:
Byung Jin AHN
1
;
Dong Seok YIM
;
Dong Gun LEE
;
Jae Cheol KWON
;
Si Hyun KIM
;
Su Mi CHOI
Author Information
1. Department of Medicine, Graduate School, Dongguk University, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Teicoplanin;
Staphylococcus aureus;
neutropenia;
pharmacokinetics;
pharmacodynamics
- MeSH:
Anti-Bacterial Agents/administration & dosage/*pharmacology/therapeutic use;
Computer Simulation;
Dose-Response Relationship, Drug;
Fever/drug therapy/microbiology;
Humans;
Microbial Sensitivity Tests;
Neutropenia/drug therapy/microbiology;
Republic of Korea;
Staphylococcal Infections/drug therapy;
Staphylococcus aureus/*drug effects;
Teicoplanin/administration & dosage/*pharmacology/therapeutic use;
Treatment Outcome
- From:Yonsei Medical Journal
2011;52(4):616-623
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The present study was conducted to determine and compare the target attainment rate (TAR) between microorganism-nonspecific (Ctrough) and microorganism-specific (AUC24/MIC) targets over two weeks of teicoplanin administration according to several dose regimens for the treatment of Staphylococcus aureus in Korean patients with neutropenic fever. MATERIALS AND METHODS: One thousand virtual concentrations were obtained for each dose using the population pharmacokinetic parameters of teicoplanin adopted from a published study. Simulation of 1,000 virtual MICs was performed using the MICs of 78 clinical isolates of S. aureus collected from a hospital in Korea. Thereafter, these simulated MICs were randomly allocated to 1,000 virtual patients in whom the TARs for AUC24/MIC >125 [or 345] and Ctrough >10 [or 20] mg/L were determined. The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC24/MIC >125 [or 345] using logistic analysis. RESULTS: The standard dose regimen of teicoplanin showed TARs of about 70% [or 33%] and 70% [or 20%] at steady-state in cases with AUC24/MIC >125 [or 345] and Ctrough >10 [or 20] mg/L, respectively. CONCLUSION: The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever. To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.
