title: Pharmacokinetics of teicoplanin during plasma exchange.
abstract: OBJECTIVE: To study the elimination of teicoplanin during plasma exchange, a procedure currently used to treat a variety of disorders involving immune complexes. Teicoplanin is a glycopeptide antibiotic that exhibits a long terminal half-life (100-150 h) and is highly bound to plasma proteins (unbound fraction (fu)=0.2). METHODS: Twelve adults with systemic polyarteritis nodosa, cryoglobulinemia-induced vasculitis or dysglobulinemic neuropathy undergoing plasma exchange were studied. Each patient received intravenous teicoplanin, 6 mg/kg body weight, immediately before plasma exchange. Plasma was assayed for teicoplanin by high pressure liquid chromatography. RESULTS: A high level of protein binding of teicoplanin was measured within this patient population (98%). The mean quantity of teicoplanin eliminated (+/-SD) was 74.6+/-34.6 mg. The mean drug fraction eliminated by plasma exchange (+/-SD) was 19.5+/-5.6%. Mean fu value as determined by ultrafiltration (+/-SD) was 2.2+/-1.7%. CONCLUSIONS: These results show that plasma exchange influences teicoplanin pharmacokinetics, with a clinically significant quantity being eliminated. If trough teicoplanin concentrations of around 10 mg/L are desired, it is recommended that teicoplanin dosage be supplemented or given after plasma exchange.
authors.affiliation: Départment de Pharmacologie-Toxicologie.
authors.forename: Patrice
authors.initials: P
authors.lastname: Alet
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.forename: Francis
authors.initials: F
authors.lastname: Fauvelle
authors.forename: Michel
authors.initials: M
authors.lastname: Tod
authors.forename: Thierry
authors.initials: T
authors.lastname: Genereau
authors.forename: Mohamed
authors.initials: M
authors.lastname: Louchahi
authors.forename: Anne
authors.initials: A
authors.lastname: Leon
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.forename: Olivier
authors.initials: O
authors.lastname: Petitjean