Clinical efficacy of high dose treatment with teicoplanin (TEIC) against MRSA infections and trough concentration of TEIC

• Published in: Japanese Journal of Chemotherapy Vol. 55; no. 1; pp. 8 - 16
• Main Authors: Ueda Yasuharu, Noguchi Shusaku, Makin Masahiko, Kamisasa Hiroshi, Mochizuki Toru, Unemoto Kyoko, Kurokawa Akira
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 01.01.2007; 公益社団法人 日本化学療法学会
• Subjects: high dose administration; MRSA; pharmacokinetics; severe infection; teicoplanin
• ISSN: 1340-7007; 1884-5886
• DOI: 10.11250/chemotherapy1995.55.8

We analyzed the clinical efficacy of high dose teicoplanin (TEIC)(1, 600 mg/24 h for the first day and 800 mg/24 h thereafter) and plasma trough concentration of TEIC in MRSA infections in Emergency and Critical Care Medicine, to examine the relationship between a change in the trough concentration after administration of this drug and efficacy and safety.Results are as follows:1. The clinical efficacy of TEIC against 10 cases of pneumonia, 2 of septicemia with wound infection due toMRSA was 100%.2. The bacteriological effectiveness of TEIC consisted of 9 eradicated, 1 decreased, 2 replaced, and O unchanged. Among 8 patients treated with TEIC alone, it consisted of 7 eradicated, O decreased, 1 replaced, and O unchanged. Among 4 patients concomitantly treated with other drugs, it consisted of 2 eradicated, 1 decreased, 1 replaced, and O unchanged. Four of 12 patients showed multibacterial infection with Pseudomonas aeruginosa.3. No case administered TEIC was found to have any side effects or abnormal laboratory findings. 4. The trough blood TEIC level slightly decreased to 17.5 ±6.7 μg/mL on day 2 and 16.3 ±6.3μg/mL on day 4, showing a steady state, and accumulation of TEIC was as mild as 20.5 ±6.9μg/mL on day 8. There5. High-dose treatment with TEIC showed highly sharp efficacy and high safety, which was considered to be a very useful method for treatment of severe MRSA infections. was no variation of blood concentrations in the respective patients, moreover. 救急領域におけるmethicillin-resistant Staphylococcus aums (MRSA) 感染症に対するteicoplanin (TEIC) の高用量投与 (初日1,600mg/日, 以降800mg/日) を実施し, 本薬剤投与後の血中トラフ値推移と有効性および安全性との関係について検討し, 下記の成績が得られた。(1) MRSAに起因する肺炎10例, 創部感染症2例に対するTEICの臨床的有効率は, 100%であった。(2) 細菌学的効果は全症例のうち, 消失9例, 減少1例, 菌交代2例, 不変0例であった。TEIC単独治療8例では消失7例, 減少0例, 菌交代1例, 不変0例で, 他薬剤併用治療4例では消失2例, 減少1例, 菌交代1例, 不変0例であった。なお全12例中4例にPseudomoms aeruginosaとの複数菌感染が認められた。(3) 投与例では本薬剤に起因する副作用は認められなかった。(4) TEIC血中トラフ値は, day2で17.5±6.7μg/mL, day4で163±6.3μg/mLと若干低下するものの定常状態となり, day8でも20.5±6.9μg/mLとTEICの蓄積は軽微であった。さらに各症例で, 血中濃度のばらつきも認めなかった。(5) TEICの高用量投与はその効果に抜群のキレがあり, しかも安全性の高いことが示され, 重症MRSA感染症の治療において非常に有用な投与法であると考えられた。