title: [Necessity of personalized initial loading dose calculation of teicoplanin by clinical pharmacist-examination of the utility of using systemic inflammatory response syndrome score-].
abstract: When teicoplanin (TEIC) is injected at the maintenance dose, a long period is required for achievement of the target plasma trough concentration because of its long elimination half-life. An initial loading dose is necessary for rapid achievement of an effective plasma trough concentration. Thus, we proposed that it is necessary for a pharmacist determine the initial loading dose of TEIC to reach an effective plasma trough concentration rapidly after its administration to a patient. In the present study, we evaluated the effectiveness of initial loading dose determination by pharmacists and physicians by comparing the achievement rate of target plasma trough concentrations (>15 μg/mL) and expression of adverse effects. Among 61 patients, 34 were treated according to an initial loading dose determined by a pharmacist (pharmacist intervention) and 27 were treated according to the treating physician's discretion (non-pharmacist intervention). The achievement rate of target concentrations was 91.2% (plasma trough concentration 23.3±5.3 μg/mL) in the pharmacist intervention group and 25.9% (plasma trough concentration 14.0±5.9 μg/mL) in the non-pharmacist intervention group. There was no difference in the incidence of adverse effects between the two groups. Also, we found that systemic inflammatory response syndrome (SIRS) may have a correlation with plasma trough concentrations of TEIC. We suggest that the SIRS score could become a means way of determining initial loading dose. These findings suggest that it is potentially effective for a pharmacist to determine this initial dose in order to rapidly achieve the target plasma trough concentration of TEIC.
authors.affiliation: Department of Pharmacy, Fukuoka University Hospital.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nakano
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Togawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Takata
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ishikura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Mishima
authors.forename: Koujiro
authors.initials: K
authors.lastname: Futagami
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D057285:Precision Medicine; D018746:Systemic Inflammatory Response Syndrome; D017334:Teicoplanin / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin