Simplified dosing regimens of teicoplanin for patient groups stratified by renal function and weight using Monte Carlo simulation

Takaaki Yamada, Toshiharu Nonaka, Takahisa Yano, Toshio Kubota, Nobuaki Egashira, Takehiro Kawashiri, Ryozo Oishi

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Abstract

The purpose of this study was (i) to determine the optimal dosage of teicoplanin for each patient group stratified by renal function and weight based on a population pharmacokinetic model and observed distribution of patient characteristics and (ii) to develop new simplified dosing regimens designed to achieve 15-30 μg/mL. Patient data were collected retrospectively from routine therapeutic drug monitoring files of adult patients who were given the standard loading dose regimen of teicoplanin (400 mg twice on Day 1, followed by 400 mg once daily for 2 days) and whose trough concentration was measured just before administration on Day 4. Monte Carlo simulation was conducted to estimate the trough concentration at 72 h after the initial loading dose (Cmin 72 h) and at steady state (Css min). The percentage of observed Cmin 72 h in patients who received the standard loading dose regimen outside the non-parametric 90% prediction interval (from 5th to 95th percentile) of the simulated Cmin 72 h was <10%. Simplified loading dose and maintenance dose regimens for each group stratified by renal function and weight were created to achieve Cmin 72 h and Css min of 15 μg/mL and 20-25 μg/mL, respectively. The percentage of Cmin 72 h and Css min in the range 15-30 μg/mL was 43-65% and 61-82% across each renal function and weight strata, respectively. These new simplified dosing regimens of teicoplanin could be helpful in individual adjustment of the loading and maintenance doses to achieve 15-30 μg/mL.

Original languageEnglish
Pages (from-to)344-348
Number of pages5
JournalInternational Journal of Antimicrobial Agents
Volume40
Issue number4
DOIs
Publication statusPublished - Oct 1 2012

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All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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