Serum and tissue levels of teicoplanin during cardiac surgery: the effect of a high dose regimen.
Two prospective trials suggested that teicoplanin was less effective in preventing Gram-positive wound infections after cardiac surgery than a combination of flucloxacillin and an aminoglycoside. The initial dose of 400 mg was associated with a subinhibitory concentration of teicoplanin in fat at the end of operation. In this study, the behaviour of a higher initial dose (12 mg/kg) was investigated in ten patients during coronary artery surgery. As in the earlier trials, a second dose (400 mg) was given after 24 h. The mean concentration at the end of cardiopulmonary bypass was 15 mg/l in serum, 6 mg/kg in fat and 9 mg/kg in skin, all in excess of the expected break-point for staphylococci (4 mg/l). The higher dose regimen might be more successful in surgical prophylaxis.
Wilson
A P
AP
Department of Microbiology, University College and Middlesex Hospitals, London, UK.
Shankar
S
S
Felmingham
D
D
Treasure
T
T
Grüneberg
R N
RN
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood* / Q000378:metabolism; D001681:Biological Assay; D006348:Cardiac Surgical Procedures; D005260:Female; D006020:Glycopeptides / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D006207:Half-Life; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D017334:Teicoplanin
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D017334:Teicoplanin