Teicoplanin dose
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I notice Goodman & Gilman's covers the PK of teicoplanin but doesn't give specific dosing regimens for teicoplanin itself. Let me check if there's dedicated teicoplanin dosing info elsewhere in the database.
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Teicoplanin Dosing
Teicoplanin is a glycopeptide antibiotic active against gram-positive organisms (including MRSA and enterococci). Key dosing details from authoritative sources:
Standard Adult Dosing
Loading dose: 15–20 mg/kg IV every 12 hours × 3 doses (to rapidly achieve therapeutic levels given the drug's long half-life)
Maintenance dose: 6–12 mg/kg IV/IM once daily
- For serious infections (endocarditis, osteomyelitis, bacteraemia): higher end of dosing — up to 12 mg/kg once daily, with some protocols using 15–20 mg/kg loading doses
- Standard infections: 6 mg/kg once daily is often adequate
For serious infections, a loading regimen of 15–20 mg/kg IV q12h × 3 doses is used, then maintenance — Brenner & Rector's The Kidney
Pharmacokinetics (relevant to dosing)
| Parameter | Value |
|---|---|
| Route | IV or IM (unlike vancomycin which is IV only) |
| Protein binding | 90–95% |
| Half-life (t½) | Up to 100 hours |
| Dosing frequency | Once daily (long t½ allows this) |
| Elimination | Glomerular filtration (renal) |
An IV dose of 1 g produces plasma concentrations of 15–30 μg/mL at 1 hour post-infusion. — Goodman & Gilman's Pharmacological Basis of Therapeutics
Renal Impairment
- Dose reduction required when CrCl < 50–60 mL/min — Comprehensive Clinical Nephrology, 7th Ed.
- In dialysis patients: teicoplanin can be given at 5–7 day intervals due to its very long half-life, making it practical for peritoneal dialysis patients — Brenner & Rector's The Kidney
Therapeutic Drug Monitoring (TDM)
Target trough levels:
- Routine infections: 10–15 mg/L
- Serious infections (endocarditis, MRSA, bone/joint): 15–30 mg/L (some guidelines target ≥20 mg/L)
Key Clinical Notes
- No "red man syndrome" — unlike vancomycin, infusion-related flushing reactions are generally not observed with teicoplanin
- Active against MRSA, MRSE, and most enterococci; vanA-type resistance confers resistance to teicoplanin (unlike vanB which often preserves susceptibility)
- Can be given IM (advantage over vancomycin)
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