Teicoplanin

Indications

Teicoplanin is used for: Gram-positive infection, CAPD-associated peritonitis

Adult Dose

Parenteral Severe Gram-positive infections Adult: Initially, 6 mg/kg on first day, followed by 3 mg/kg/day. Severe infection: 6 mg/kg every 12 hr for the 1st 3 doses followed by 6 mg/kg/day. Doses may be given via IM inj, IV bolus or IV infusion over 30 minutes. Intravenous Prophylaxis of Gram-positive infection in high-risk patients undergoing surgery Adult: 400 mg as single dose at induction of anesth. Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis Adult: If the patient is febrile, an initial loading dose of 400 mg may be given. Teicoplanin is added to the dialysis solution at a concentration of 20 mg/litre; dose is added into each bag of solution in the first wk, followed by alternate bags in the second wk and then in the overnight dwell bag in the third wk.

Child Dose

Parenteral Severe Gram-positive infections Child: Loading dose: 10 mg/kg every 12 hr for 3 doses followed by 6-10 mg/kg/day depending on severity of the infection. Neonates: Loading dose: 16 mg/kg on the 1st day, followed by maintenance doses of 8 mg/kg/day by IV infusion.

Renal Dose

Parenteral Renal impairment: Usual dose to be given for first 3 days, thereafter adjust dose according to CrCl. CrCl (ml/min) Dosage Recommendation 40-60 1/2 initial dose given daily or initial dose every 2 days. <40 1/3 initial dose given daily or initial dose every 3 days. Intravenous Renal impairment: Dose adjustment may be required.

Administration

Contra Indications

Hypersensitivity.

Precautions

Preexisting renal insufficiency, hypersensitivity to vancomycin. Perform periodic haematological studies, renal, LFT. Pregnancy, lactation.

Pregnancy-Lactation

Interactions

Other nephrotoxic and/or neurotoxic drugs.

Adverse Effects

Side effects of Teicoplanin : Fever, chills, allergic reactions, GI disturbances, headache, dizziness, "red-man" syndrome, disturbances in liver enzymes, renal impairment, ototoxicity, blood dyscrasias. Pain, erythema, thrombophloebitis, abscess at site of admin. Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.

Mechanism of Action

Glycopeptide antibiotic with spectrum of activity is similar to vancomycin but teicoplanin may be more active in vitro against enterococci and some anaerobic organisms but some coagulase-negative Staphylococci are less sensitive to teicoplanin than to vancomycin.