Steady-state trough serum and epithelial lining fluid concentrations of teicoplanin 12 mg/kg per day in patients with ventilator-associated pneumonia.
OBJECTIVE
To determine the steady-state trough serum and epithelial lining fluid (ELF) concentrations of teicoplanin 12 mg/kg per day in critically ill patients with ventilator associated pneumonia.


METHODS
Prospective, pharmacokinetic study in the surgical intensive care unit in a university hospital.


METHODS
Thirteen adult patients with nosocomial bacterial pneumonia on mechanical ventilation were enrolled.


METHODS
All subjects received a 30-min intravenous infusion of 12 mg/kg teicoplanin every 12 h for 2 consecutive days followed by 12 mg/kg once daily. Teicoplanin concentrations in serum and ELF were determined simultaneously 4-6 days after antibiotic administration started.


RESULTS
The median total and free concentrations of teicoplanin in serum at trough were 15.9 microg/ml (range 8.8-29.9) and 3.7 (2.0-5.4), respectively. The concentration in ELF was 4.9 (2.0-11.8).


CONCLUSIONS
In critically ill patients with ventilator-associated pneumonia the administration of high teicoplanin doses is required to reach sufficient trough antibiotic concentrations in lung tissues at steady state. At that time trough-free concentrations of teicoplanin in serum and ELF are comparable.
Département d'Anesthésie et Réanimation Chirurgicale, Centre Hospitalier et Universitaire de Poitiers, Poitiers, France. o.mimoz@chu-poitiers.fr
Olivier
O
Mimoz
Delphine
D
Rolland
Michèle
M
Adoun
Sandrine
S
Marchand
Dominique
D
Breilh
Ivan
I
Brumpt
Bertrand
B
Debaene
William
W
Couet
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000032:analysis* / Q000097:blood / Q000493:pharmacokinetics; D003422:Critical Care; D004847:Epithelial Cells; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy*; D011446:Prospective Studies; D017334:Teicoplanin / Q000008:administration & dosage* / Q000032:analysis* / Q000097:blood / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D017334:Teicoplanin