title: Retrospective study of teicoplanin loading regimen that rapidly achieves target 15-30 μg/mL serum trough concentration.
abstract: OBJECTIVE
  There are several studies of assessment for teicoplanin loading dose regimen. However, the optimal loading dose achieving the target range 15-30 μg/mL has been still unclear. We investigated the probability of target attachment as teicoplanin concentration 15-30 μg/mL at the 3rd day after teicoplanin therapy started, clinical efficacy and safety in retrospective study.
  
  
  METHODS
  In total, 42 patients treated with teicoplanin from January 2010 to July 2014 at Aichi Medical University Hospital were divided into three groups; group 1 (about 40 mg/kg for 2 days), group 2 (about 35 mg/kg for 2 days) and group 3 (about 30 mg/kg for 2 days; the previous regimen). The probability of target attachment as teicoplanin concentration, efficacy and toxicity were compared among three groups.
  
  
  RESULTS
  The proportion of patients achieving the target range was 100% in group 1, 57.9% in group 2, and 38.9% in group 3 (p = 0.05). The percentage of patients that showed hepatotoxicity and nephrotoxicity was not different from three groups (hepatotoxicity: group 1, 20%; group 2, 21.1%; group 3, 16.7%: p = 0.48; nephrotoxicity: group 1, 0%; group 2, 5.3%; group 3, 16.7%: p = 0.38). Finally, there were not significant differences of clinical efficacy among three regimens, but CRP 4-7 day after teicoplanin therapy in group 1 and group 2 exhibited a significant lower value, compared with group 3.
  
  
  CONCLUSIONS
  We suggested that 35-40 mg/kg for 2 days as a loading does would be needed for the early achieving target range (15-30 μg/mL) and improvement of infection.
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan; Department of Pharmacy, Aichi Medical University School of Medicine, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan; Department of Pharmacy, Aichi Medical University School of Medicine, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan; Department of Pharmacy, Aichi Medical University School of Medicine, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hirai
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Nishiyama
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koizumi
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamagishi
authors.affiliation: Department of Pharmacy, Aichi Medical University School of Medicine, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University School of Medicine, Japan. Electronic address: mikamo@aichi-med-u.ac.jp.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Mikamo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics* / Q000633:toxicity; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007668:Kidney / Q000187:drug effects; D008099:Liver / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D017334:Teicoplanin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics* / Q000633:toxicity
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D017334:Teicoplanin
keywords: Hepatopathy; Loading dose; Teicoplanin; Trough level