Loading, maintenance doses of teicoplanin need adjustments in MRSA patients

A recent study recommends adjusting both loading dosing and maintenance dosing regimens of teicoplanin based on the renal function and serum albumin concentration of patients with methicillin-resistant staphylococcus aureus (MRSA) infection.

“In addition, it is necessary to perform follow-up therapeutic drug monitoring of teicoplanin at least once every week,” the authors said.

This retrospective study enrolled 115 Chinese adult patients with complicated or noncomplicated MRSA and identified creatinine clearance (CrCL) and albumin as covariates on the clearance of teicoplanin.

For the treatment of noncomplicated MRSA infections in patients with normal renal function and serum albumin concentration, the authors recommended a dosing regimen of 600 mg q12h, with five administrations as the loading dose followed by 600 mg qd as the maintenance dose.

For patients with serious or complicated MRSA infections, the recommended dosing regimen was 800 mg q12h, with five administrations as the loading dose followed by 800 mg qd as the maintenance dose.

“It is worth noting that both the loading and maintenance doses ought to be modified based on the patient's renal function and serum albumin concentration,” the authors said. “In addition, trough concentrations of teicoplanin were significantly increased every other week.”

This study estimated pharmacokinetics parameters using nonlinear mixed-effects modelling. The authors assessed the attainment of various dosing regimens in achieving the target trough concentrations in patients with normal or decreased renal function using Monte Carlo simulations.