Measurement of Teicoplanin Concentration with Lc-Ms/Ms Method Demonstrates the Usefulness of Therapeutic Drug Monitoring in Hematologic Patient Populations

• Published in: Therapeutic drug monitoring
• Main Authors: Chae, Hyojin, Lee, Jeong Joong, Cha, Kyoungho, Her, Su Hyun, Kim, Hyo-Young, Han, Eunhee, Kim, Myungshin, Kim, Yonggoo, Cho, Sung-Yeon, Lee, Dong-Gun
• Format: Journal Article
• Language: English
• Published: United States 27.02.2018
• ISSN: 1536-3694

Teicoplanin is a glycopeptide antibiotic that has become increasingly popular with the spread of methicillin-resistant Staphylococcus aureus. The aim of the study was to develop and validate a UHPLC-MS/MS (ultra-high performance liquid chromatography tandem mass spectrometry) method for teicoplanin, and analyze trough teicoplanin concentrations achieved in patients with hematological diseases. The UHPLC-MS/MS method for teicoplanin was developed, validated, and applied in a retrospective analysis of trough plasma teicoplanin concentrations from 305 patients receiving standard dose, and 17 patients receiving TDM-guided individualized dose. The linear range was 3.9-52.9 mg/L. The imprecision was less than 12%, the limits of detection and quantification were less than 0.13 and 0.72 mg/L, respectively. The sample carry-over and ion suppression were insignificant. In the standard dose group, the median teicoplanin concentrations were 7.5 mg/L (days 3-5) and 8.9 mg/L (on days 6-8) and the proportion of trough levels achieving ≥10 mg/L, was 20% (days 3-5) and 38% (days 6-8), respectively. In the TDM-guided individualized dose group, median teicoplanin concentration was higher (16.9 mg/L), and the proportion of trough levels ≥10 mg/L was also higher (77%) when compared with the standard dose group CONCLUSIONS:: Based on these results, the present UHPLC-MS/MS method can be considered suitable for routine TDM of teicoplanin. Also based on the insufficient trough teicoplanin concentrations achieved with standard dose regimen, and the higher trough teicoplanin concentrations achieved with TDM-guided individualized dose regimen, this study highlights the importance of TDM of teicoplanin, especially in high-risk patient groups.