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

• Published in: YAKUGAKU ZASSHI Vol. 136; no. 9; pp. 1313 - 1317
• Main Authors: Higa, Futoshi, Nakamura, Katsunori, Shiohira, Hideo, Kise, Yuya, Fujita, Jiro, Ueda, Shinichiro, Tateyama, Masao, Kuniyoshi, Yukio, Nakamatsu, Masashi, Hokama, Nobuo
• Format: Journal Article
• Language: Japanese
• Published: The Pharmaceutical Society of Japan 01.09.2016; Pharmaceutical Society of Japan
• Subjects: bacteremia; methicillin-resistant Staphylococcus aureus; renal impairment; teicoplanin; therapeutic drug monitoring
• ISSN: 0031-6903; 1347-5231
• DOI: 10.1248/yakushi.15-00296

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.