Steady-state trough serum and epithelial lining fluid concentrations of teicoplanin 12 mg/kg per day in patients with ventilator-associated pneumonia.

Abstract

OBJECTIVE:

To determine the steady-state trough serum and epithelial lining fluid (ELF) concentrations of teicoplanin 12 mg/kg per day in critically ill patients with ventilator associated pneumonia.

DESIGN AND SETTING:

Prospective, pharmacokinetic study in the surgical intensive care unit in a university hospital.

PATIENTS:

Thirteen adult patients with nosocomial bacterial pneumonia on mechanical ventilation were enrolled.

INTERVENTIONS:

All subjects received a 30-min intravenous infusion of 12 mg/kg teicoplanin every 12 h for 2 consecutive days followed by 12 mg/kg once daily. Teicoplanin concentrations in serum and ELF were determined simultaneously 4-6 days after antibiotic administration started.

MEASUREMENTS AND RESULTS:

The median total and free concentrations of teicoplanin in serum at trough were 15.9 microg/ml (range 8.8-29.9) and 3.7 (2.0-5.4), respectively. The concentration in ELF was 4.9 (2.0-11.8).

CONCLUSIONS:

In critically ill patients with ventilator-associated pneumonia the administration of high teicoplanin doses is required to reach sufficient trough antibiotic concentrations in lung tissues at steady state. At that time trough-free concentrations of teicoplanin in serum and ELF are comparable.

• Authors: Olivier Mimoz, Delphine Rolland, Michèle Adoun, Sandrine Marchand, Dominique Breilh, Ivan Brumpt, Bertrand Debaene, William Couet
• Journal: Intensive care medicine (Intensive Care Med) Vol. 32 Issue 5 Pg. 775-9 (May 2006) ISSN: 0342-4642 [Print] United States
• PMID: 16550370 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Teicoplanin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (administration & dosage, analysis, blood, pharmacokinetics)
• Critical Care
• Epithelial Cells
• Female
• Humans
• Lung (physiopathology)
• Male
• Middle Aged
• Pneumonia, Ventilator-Associated (drug therapy)
• Prospective Studies
• Teicoplanin (administration & dosage, analysis, blood, pharmacokinetics)