Therapeutic drug monitoring of the teicoplanin trough level after the loading doses in patients receiving venoarterial extracorporeal membrane oxygenation
Journal
Journal of the Formosan Medical Association
Journal Volume
119
Journal Issue
6
Pages
1086-1092
Date Issued
2020
Author(s)
Abstract
Background: The optimal loading dose of teicoplanin in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) has never been determined by therapeutic drug monitoring. This study investigated the appropriateness of proposed loading dose regimens of teicoplanin when administered to patients receiving VA-ECMO by using a previously proposed loading dosage and measuring the teicoplanin trough concentration (Ctrough). Methods: Patients who initiated teicoplanin therapy while receiving VA-ECMO were enrolled. Every included patient received four loading doses of teicoplanin at a dose of 12 mg/kg. The first three doses were administered 12 h apart, and the fourth dose was administered 24 h after the third dose. Blood samples were collected before administering the maintenance dose (i.e., the fifth dose), and the teicoplanin Ctrough was measured. Serum teicoplanin levels were determined using an Agilent 1290 ultra-high performance liquid chromatography system. Results: The teicoplanin Ctrough was successfully tested in 11 patients. Their median age was 68.2 years, and 81.8% of them were men. The median of each loading dose was 11.6 (range, 10.7–12.8) mg/kg. The median teicoplanin Ctrough was 22.01 (range, 14.85–44.84) mg/L. All patients had a Ctrough of more than 10 mg/L, whereas 90.9% (10/11) of the patients achieved a Ctrough of more than 15 mg/L. Conclusion: The loading dosage consisting of four doses of teicoplanin administered within the first 72 h at a dose of 12 mg/kg/dose could achieve an adequate therapeutic Ctrough of teicoplanin in patients receiving VA-ECMO. ? 2019 Formosan Medical Association
SDGs
Other Subjects
teicoplanin; antiinfective agent; teicoplanin; acute kidney failure; adult; aged; Article; blood sampling; clinical article; clinical trial; cohort analysis; drug blood level; drug monitoring; extracorporeal oxygenation; female; hospital mortality; hospitalization; human; hypertransaminasemia; loading drug dose; maintenance drug dose; male; prospective study; shock; thrombocytopenia; treatment outcome; trough concentration; ultra performance liquid chromatography; drug monitoring; high performance liquid chromatography; Aged; Anti-Bacterial Agents; Chromatography, High Pressure Liquid; Drug Monitoring; Extracorporeal Membrane Oxygenation; Female; Humans; Male; Teicoplanin
Publisher
Elsevier B.V.
Type
journal article