Improvement of Predictivity of Teicoplanin Serum Trough Concentrations at Steady State Calculated by Vancomycin Pharmacokinetic Parameter

According to a recent study and meta-analysis, trough levels of >10 mu g/mL teicoplanin (TEIC) may be acceptable for the treatment of uncomplicated infection, but no method of TEIC personalized medicine has been established. Vancomycin (VCM) and TEIC are glycopeptide antibiotic agents effective against methicillin-resistance Staphyloccocus aureus. This study aimed to establish TEIC personalized medicine at a steady state calculated by VCM pharmacokinetic parameters. Bayesian forecasting and population mean methods were employed to estimate individual total VCM clearance (CL) using existing population pharmacokinetics (PPK) parameter, and the differences between the CL calculated by these two methods were defined as Delta CL. Serum drug concentration data for patients treated with TEIC were collected at a steady state concentration (>96 h post infusion). There was a significant relationship between the prediction error of TEIC trough level and Delta CL. The relation between Delta CL and TEIC trough concentration at steady state was used to develop the following equation to determine the maintenance dose: TEIC (mu g/mL) =1.1119X-6.124 Delta CL+3.9164 (Xis defined as TEIC trough concentration calculated from the PPK parameter). The results of this study indicated that it is possible to improve the prediction error of TEIC trough concentration at a steady state for patients who have received VCM therapy.