title: Therapeutic drug concentrations of teicoplanin in clinical settings.
abstract: BACKGROUND
  Teicoplanin is a glycopeptide antibiotic that is widely used in clinical practice for the treatment of infections caused by drug-resistant Gram-positive bacteria. The aim of this study was to analyze plasma teicoplanin concentrations to determine the percentage of patients in whom therapeutic concentrations of teicoplanin were achieved in clinical practice.
  
  
  METHODS
  The plasma teicoplanin concentrations of hospitalized patients receiving treatment at a teaching hospital were retrospectively analyzed. The target level was defined as a plasma teicoplanin concentration of 10 mg/L or greater, since this was generally regarded as the lower limit of the optimal concentration range required for the effective treatment of a majority of infections.
  
  
  RESULTS
  Patients with sub-optimal (< 10 mg/L) plasma teicoplanin concentrations constituted nearly half of the total study population. The majority of these patients received the recommended loading dose, which were three 400 mg doses administered every 12 hours. Sub-group analysis showed a trend that the group receiving loading dose was more likely to reach the optimal teicoplanin concentration.
  
  
  CONCLUSIONS
  The data revealed that a significant proportion of patients in clinical practice achieved only sub-optimal teicoplanin concentrations, which emphasizes the importance of the mandatory use of loading dose and routine therapeutic drug monitoring. Treatment reassessment and simulation of individual dose regimens may also be necessary to achieve optimal drug concentrations.
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: So-Yun
authors.initials: SY
authors.lastname: Nah
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Im
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Jin Yeob
authors.initials: JY
authors.lastname: Yeo
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Ji-Hyeon
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. ; Inha University Hospital Clinical Trial Center, Incheon, Korea.
authors.forename: Cheol-Woo
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. ; Inha University Hospital Clinical Trial Center, Incheon, Korea.
authors.forename: Moon-Seok
authors.initials: MS
authors.lastname: Nam
authors.affiliation: Department of Pharmacy, Inha University Hospital, Incheon, Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Moon-Hyun
authors.initials: MH
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Jin-Soo
authors.initials: JS
authors.lastname: Lee
keywords: Dosing regimen; Drug monitoring; Loading dose; Teicoplanin