Long-term Treatment of Teicoplanin for Methicillin-resistant Staphylococcus aureus Sternal Osteomyelitis with Renal Impairment: A Case of High Teicoplanin Trough Levels Maintained by Therapeutic Drug Monitoring.
Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic drug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment. Plasma teicoplanin trough levels were maintained at a high range (20-30 μg/mL). Although the patient required long-term teicoplanin treatment, a further decline in renal function was not observed, and blood culture remained negative after the start of treatment. Teicoplanin treatment that is maintained at a high trough level by therapeutic drug monitoring might be beneficial for severe methicillin-resistant Staphylococcus aureus infection accompanied by renal impairment.
Department of Hospital Pharmacy, Faculty of Medicine, University of the Ryukyus.
Hideo
H
Shiohira
Masashi
M
Nakamatsu
Yuya
Y
Kise
Futoshi
F
Higa
Masao
M
Tateyama
Nobuo
N
Hokama
Yukio
Y
Kuniyoshi
Shinichiro
S
Ueda
Katsunori
K
Nakamura
Jiro
J
Fujita
D000368:Aged; D016903:Drug Monitoring; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010019:Osteomyelitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000150:complications*; D012720:Severity of Illness Index; D013203:Staphylococcal Infections; D013249:Sternum; D017334:Teicoplanin / Q000008:administration & dosage* / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D017334:Teicoplanin