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Long-term Treatment of Teicoplanin for Methicillin-resistant Staphylococcus aureus Sternal Osteomyelitis with Renal Impairment: A Case of High Teicoplanin Trough Levels Maintained by Therapeutic Drug Monitoring.

Abstract
Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic drug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment. Plasma teicoplanin trough levels were maintained at a high range (20-30 μg/mL). Although the patient required long-term teicoplanin treatment, a further decline in renal function was not observed, and blood culture remained negative after the start of treatment. Teicoplanin treatment that is maintained at a high trough level by therapeutic drug monitoring might be beneficial for severe methicillin-resistant Staphylococcus aureus infection accompanied by renal impairment.
AuthorsHideo Shiohira, Masashi Nakamatsu, Yuya Kise, Futoshi Higa, Masao Tateyama, Nobuo Hokama, Yukio Kuniyoshi, Shinichiro Ueda, Katsunori Nakamura, Jiro Fujita
JournalYakugaku zasshi : Journal of the Pharmaceutical Society of Japan (Yakugaku Zasshi) Vol. 136 Issue 9 Pg. 1313-7 ( 2016) ISSN: 1347-5231 [Electronic] Japan
PMID27592834 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Teicoplanin
Topics
  • Aged
  • Drug Monitoring
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Osteomyelitis (complications, drug therapy, microbiology)
  • Postoperative Complications
  • Renal Insufficiency (complications)
  • Severity of Illness Index
  • Staphylococcal Infections
  • Sternum
  • Teicoplanin (administration & dosage, blood)
  • Time Factors
  • Treatment Outcome

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