title: [Specific variability of teicoplanin protein binding in patients receiving continuous hemodiafiltration-comparison with hypoalbuminemia patients].
abstract: Variation in protein binding ratio (PBR) of teicoplanin (TEIC) was investigated in continuous hemodiafiltration (CHDF) patients. TEIC is classified as a high PBR drug (≧90%), and it was reported that the PBR of TEIC decreased with an decrease in the serum albumin level in hypoalbuminemia patients. However, few reports can be found about the variation of PBR of TEIC for CHDF patient. An antibiotic activity is directly determined by the level of unbound antibiotics species (Cfree) in the target site, namely, an increase in the Cfree enhances the risks of TEIC as well as the therapeutic effect against Methicillin-resistant Staphylococcus aureus (MRSA). In this study, both the total concentration (Ctotal) and Cfree of TEIC were determined and the PBRs were compared between a patient with normal albumin level, hypoalbuminemia patients and CHDF patients. Similarly to the previous report, the lowering of PBR of TEIC was demonstrated in the hypoalbuminemia patients. On the other hand, the CHDF patients showed lower value of PBR suggesting some change in the protein binding ability, although showed higher values of serum albumin level in comparison with the hypoalbuminemia patients. It was not necessary to measure the Cfree value for the hypoalbuminemia patient routinely, but the monitoring of Cfree as well as Ctotal for the CHDF patients can be important for the proper TEIC use because of the potential specialty of PBR.
authors.affiliation: Department of Pharmacy, University Hospital, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. hiromiy@yamanashi.ac.jp
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yanagimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Teramatsu
authors.forename: Junko
authors.initials: J
authors.lastname: Goto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yanagisawa
authors.forename: Norikazu
authors.initials: N
authors.lastname: Harii
authors.forename: Masahiko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Takehisa
authors.initials: T
authors.lastname: Hanawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuda
authors.forename: Toshio
authors.initials: T
authors.lastname: Oguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000378:metabolism*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008875:Middle Aged; D011485:Protein Binding; D012709:Serum Albumin / Q000378:metabolism; D017334:Teicoplanin / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D012709:Serum Albumin; D017334:Teicoplanin