Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: A consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Yuki Hanai, Yoshiko Takahashi, Takashi Niwa, Toshihiko Mayumi, Yukihiro Hamada, Toshimi Kimura, Kazuaki Matsumoto, Satoshi Fujii, Yoshio Takesue

研究成果: Article査読

2 被引用数 (Scopus)

抄録

Background: Owing to its low risk of adverse effects, teicoplanin has been extensively used in patients with infections caused by MRSA. To promote the better management of patients receiving teicoplanin, we have updated the guidelines for therapeutic drug monitoring (TDM). Methods: The guidelines were developed by a committee following the methodology handbook published by the Japanese Medical Information Distribution Service. Nine clinical questions were selected. The committee conducted a systematic review and meta-analysis to establish evidence-based recommendations for the target trough concentration (Cmin). An initial electronic database search returned 515 articles, and 97 articles qualified for a full review. Four and five studies were included for the efficacy evaluation of cut-off Cmin values of 15 and 20 mg/L, respectively. Results: Compared with Cmin < 15 mg/L, a target Cmin value of 15-30 mg/L resulted in increased clinical efficacy in patients with non-complicated MRSA infections (OR = 2.68; 95% CI = 1.14-6.32) without an increase in adverse effects. Although there was insufficient evidence, target Cmin values of 20-40 mg/L were suggested in patients with complicated or serious MRSA infections. A 3 day loading regimen followed by maintenance treatment according to renal function was recommended to achieve the target trough concentrations. Because of the prolonged half-life of teicoplanin, measurement of the Cmin value on Day 4 before reaching steady state was recommended. Conclusions: The new guideline recommendations indicate the target Cmin value for TDM and the dosage regimen to achieve this concentration and suggest practices for specific subpopulations.

本文言語English
ページ(範囲)869-879
ページ数11
ジャーナルJournal of Antimicrobial Chemotherapy
77
4
DOI
出版ステータスPublished - 2022 4月 1

ASJC Scopus subject areas

  • 薬理学
  • 微生物学(医療)
  • 感染症
  • 薬理学(医学)

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