Teicoplanin

Antibiotic Class:

Glycopeptide

Antimicrobial Spectrum:

Staphylococcus aureus (teicoplanin susceptible), Coagulase negative Staphylococci, Streptococcus pneumoniae, Streptococcus spp., Enterococcus spp. (Teicoplanin susceptible), C. jeikeium, Clostridium spp., L. monocytogenes, Actinomyces

Mechanism of Action:

Teicoplanin inhibits polymerization of cell wall components in susceptible bacteria

Pharmacodynamics:

No data

Pharmacokinetics:

Cmax: 53.5mg/L (after 3mg/kg dose); Half-life: 170 hours; Volume of distribution: 0.9-1.6L/kg; Protein binding: 90%

Adverse Effects:

Skin: Hypersensitivity

Hepatic: Abnormal LFTs

Otic: Ototoxicity

Other: Drug fever

Dosage:

Dosing in adults:

Serious infections: 400mg-800mgIV q12h x 1-3 days, then maintenance dose daily

Dosing in pediatrics:

3-6mg/kg/day

Disease state based dosing:

Renal failure:  CrCl > 60mL/min: Standard dosing

                    CrCl 40-60mL/min: half normal dose q24h

                     CrCl < 40mL/min: one-third maintenance dose given

Hepatic failure:  No dosing changes recommended at this time.

Contraindications/Warnings/Precautions:

Warning: Cross allergenicity may occur between patient with true allergy to vancomycin and patients receiving teicoplanin

Drug Interactions:

Ciprofloxacin: Single case report of concomitant administration leading to seizure

Pregnancy:

Unknown

Monitoring Requirements:

Therapeutic:  Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count

Toxic:  Rare reports of ototoxicity. Audiograms recommended for long term therapy.

Brand names/Manufacturer: 

Targocid/Aventis Pharmaceuticals