Institutional members access full text with Ovid®

Evaluation of Teicoplanin Trough Values After the Recommended Loading Dose in Children With Associated Safety Analysis

Yamada, Takaaki PhD; Kubota, Toshio PhD; Yonezawa, Mahoro BS; Nishio, Hisanori MD, PhD; Kanno, Shunsuke MD, PhD; Yano, Takahisa PhD; Kobayashi, Daisuke PhD; Egashira, Nobuaki PhD; Takada, Hidetoshi MD, PhD; Hara, Toshiro MD, PhD; Masuda, Satohiro PhD

Pediatric Infectious Disease Journal: April 2017 - Volume 36 - Issue 4 - p 398–400
doi: 10.1097/INF.0000000000001456
Antimicrobial Reports

Background: This study evaluated whether the recommended teicoplanin loading dose (3 loading doses of 10 mg/kg every 12 hours) achieves a 15–30 μg/mL trough levels in 26 children (2−16 years). In addition, we examined the incidences of renal impairment and hepatic dysfunction in children treated with teicoplanin.

Methods: This retrospective study was conducted between October 2008 and March 2014.

Results: The percentage of patients with a trough level <10 and <15 μg/mL were 15.4% (4/26) and 46.2% (12/26), respectively. There were significant correlations between age and concentration/cumulative loading dose (C/D) ratio (P = 0.045), serum creatinine and C/D ratio (P < 0.001) and estimated glomerular filtration rate and C/D ratio (P = 0.005). Serum creatinine was significantly lower when trough levels were <15 μg/mL compared with ≥15 μg/mL. The incidences of renal impairment and hepatic dysfunction were 2.3% and 5.8%, respectively, with no significant difference between <20 and ≥20 μg/mL trough-level groups.

Conclusions: The recommended loading dose may be insufficient to achieve 15–30 μg/mL in children with normal renal function. In addition, the target trough level ≥20 μg/mL for deep-seated infections seems to be safe in children.

From the *Department of Pharmacy, Kyushu University Hospital, Department of Clinical Pharmacy and Pharmaceutical care, Graduate School of Pharmaceutical Sciences, Kyushu University, and Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Accepted for publication September 08, 2016.

This study was supported by JSPS KAKENHI Grant Number 15K18924. The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com).

Address for correspondence: Toshio Kubota, PhD, Department of Clinical Pharmacy and Pharmaceutical care, Graduate School of Pharmaceutical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812–8582, Japan. E-mail: t-kubota@pharm.med.kyushu-u.ac.jp.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.