J Korean Med Sci.  2023 Feb;38(7):e62. 10.3346/jkms.2023.38.e62.

Optimal Use and Need for Therapeutic Drug Monitoring of Teicoplanin in Children: A Systematic Review

Affiliations
  • 1Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
  • 2Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 3Department of Pharmaceutical Services, Samsung Medical Center, Seoul, Korea
  • 4School of Pharmacy, Sungkyunkwan University, Suwon, Korea
  • 5Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 6Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background
Teicoplanin is a glycopeptide antimicrobial that treats serious invasive infections caused by gram-positive bacteria, such as the methicillin-resistant Staphylococcus aureus. Despite some comparable advantages, there is no guideline or clinical recommendation for teicoplanin in the pediatric population, unlike vancomycin where abundant studies and the recently revised guideline on therapeutic drug level monitoring (TDM) exist.
Methods
The systematic review was performed in accordance with the preferred reporting items for systematic reviews. Two authors (JSC and SHY) searched PubMed, Embase, and Cochrane Library databases using relevant terms independently.
Results
Fourteen studies were finally included with a total of 1,380 patients. TDM was available in 2,739 samples collected in the nine studies. Dosing regimens varied widely, and eight studies used recommended dosing regimens. Timing for measuring TDM was mostly 72–96 hours or longer after the initiation of the first dose, which was expected to be a steadystate. The majority of studies had target trough levels of 10 µg/mL or above. Three studies reported that the clinical efficacy and treatment success rate of teicoplanin was 71.4%, 87.5%, and 88%. Adverse events associated with teicoplanin use were described in six studies with a focus on renal and/or hepatic impairment. Except for one study, no significant relation was noted between the incidence of adverse events and trough concentration.
Conclusion
Current evidence on teicoplanin trough levels in pediatric populations is insufficient due to heterogeneity. However, target trough levels with favorable clinical efficacy are achievable by recommended dosing regimen in the majority of patients.

Keyword

Teicoplanin; Therapeutic Drug Level Monitoring; Children

Figure

  • Fig. 1 Chemical structure of teicoplanin. Source: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 30, 375-395.

  • Fig. 2 Flow diagram for the selection of eligible studies.


Reference

1. Borghi A, Coronelli C, Faniuolo L, Allievi G, Pallanza R, Gallo GG. Teichomycins, new antibiotics from Actinoplanes teichomyceticus nov. sp. IV. Separation and characterization of the components of teichomycin (teicoplanin). J Antibiot (Tokyo). 1984; 37(6):615–620. PMID: 6235204.
Article
2. Bennett J. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Amsterdam, Netherlands: Elsevier;2020. p. 387–389.
3. Wilson AP. Clinical pharmacokinetics of teicoplanin. Clin Pharmacokinet. 2000; 39(3):167–183. PMID: 11020133.
Article
4. Nakamura A, Takasu O, Sakai Y, Sakamoto T, Yamashita N, Mori S, et al. Development of a teicoplanin loading regimen that rapidly achieves target serum concentrations in critically ill patients with severe infections. J Infect Chemother. 2015; 21(6):449–455. PMID: 25726436.
Article
5. Hanai Y, Takahashi Y, Niwa T, Mayumi T, Hamada Y, Kimura T, et al. Optimal trough concentration of teicoplanin for the treatment of methicillin-resistant Staphylococcus aureus infection: a systematic review and meta-analysis. J Clin Pharm Ther. 2021; 46(3):622–632. PMID: 33547647.
Article
6. Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm. 2020; 77(11):835–864. PMID: 32191793.
Article
7. Rybak MJ, Lomaestro BM, Rotschafer JC, Moellering RC Jr, Craig WA, Billeter M, et al. Therapeutic monitoring of vancomycin in adults summary of consensus recommendations from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Pharmacotherapy. 2009; 29(11):1275–1279. PMID: 19873687.
8. He N, Su S, Ye Z, Du G, He B, Li D, et al. Evidence-based guideline for therapeutic drug monitoring of vancomycin: 2020 update by the division of therapeutic drug monitoring, Chinese Pharmacological Society. Clin Infect Dis. 2020; 71(Suppl 4):S363–S371. PMID: 33367582.
Article
9. Jorgensen SC, Dersch-Mills D, Timberlake K, Stewart JJ, Gin A, Dresser LD, et al. AUCs and 123s: a critical appraisal of vancomycin therapeutic drug monitoring in paediatrics. J Antimicrob Chemother. 2021; 76(9):2237–2251. PMID: 33675656.
Article
10. Kato H, Hagihara M, Okudaira M, Asai N, Koizumi Y, Yamagishi Y, et al. Systematic review and meta-analysis to explore optimal therapeutic range of vancomycin trough level for infected paediatric patients with Gram-positive pathogens to reduce mortality and nephrotoxicity risk. Int J Antimicrob Agents. 2021; 58(2):106393. PMID: 34174409.
Article
11. Lodise TP, Drusano G. Vancomycin area under the curve-guided dosing and monitoring for adult and pediatric patients with suspected or documented serious methicillin-resistant Staphylococcus aureus infections: putting the safety of our patients first. Clin Infect Dis. 2021; 72(9):1497–1501. PMID: 33740042.
Article
12. Rybak MJ, Le J, Lodise T, Levine D, Bradley J, Liu C, et al. Executive summary: therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. J Pediatric Infect Dis Soc. 2020; 9(3):281–284. PMID: 32659787.
13. Smit C, Goulooze SC, Brüggemann RJ, Sherwin CM, Knibbe CA. Dosing recommendations for vancomycin in children and adolescents with varying levels of obesity and renal dysfunction: a population pharmacokinetic study in 1892 children aged 1–18 years. AAPS J. 2021; 23(3):53. PMID: 33839974.
14. Cavalcanti AB, Goncalves AR, Almeida CS, Bugano DD, Silva E. Teicoplanin versus vancomycin for proven or suspected infection. Cochrane Database Syst Rev. 2010; (6):CD007022. PMID: 20556772.
15. Loane G, Gwee A. Teicoplanin therapeutic drug monitoring and treatment outcomes in children with gram-positive infections. J Pediatric Infect Dis Soc. 2021; 10(5):682–685. PMID: 33543753.
Article
16. Svetitsky S, Leibovici L, Paul M. Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis. Antimicrob Agents Chemother. 2009; 53(10):4069–4079. PMID: 19596875.
Article
17. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021; 372(160):n160. PMID: 33781993.
Article
18. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, editors. Cochrane Handbook for Systematic Reviews of Interventions. Version 6.2. London, UK: Cochrane;2022.
19. National Heart, Lung, and Blood Institute (NHLBI). Quality assessment tool for case series studies. Updated 2021. Accessed August 15, 2021. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools .
20. Kanji S, Hayes M, Ling A, Shamseer L, Chant C, Edwards DJ, et al. Reporting guidelines for clinical pharmacokinetic studies: the ClinPK statement. Clin Pharmacokinet. 2015; 5(7):783–795.
Article
21. Choi JS, Kim JM, Kim D, Kim SH, Cho H, Park HD, et al. Therapeutic drug level monitoring of teicoplanin in Korean pediatric patients with normal versus impaired renal function. J Korean Med Sci. 2020; 35(46):e376. PMID: 33258328.
Article
22. Dufort G, Ventura C, Olivé T, Ortega JJ. Teicoplanin pharmacokinetics in pediatric patients. Pediatr Infect Dis J. 1996; 15(6):494–498. PMID: 8783345.
23. Ito H, Shime N, Kosaka T. Pharmacokinetics of glycopeptide antibiotics in children. J Infect Chemother. 2013; 19(2):352–355. PMID: 22872188.
24. Jung J, Lee K, Oh J, Choi R, Woo HI, Park HD, et al. Therapeutic drug monitoring of teicoplanin using an LC-MS/MS method: analysis of 421 measurements in a naturalistic clinical setting. J Pharm Biomed Anal. 2019; 167:161–165. PMID: 30776754.
Article
25. Lemerle S, de La Rocque F, Lamy R, Fremaux A, Bernaudin F, Lobut JB, et al. Teicoplanin in combination therapy for febrile episodes in neutropenic and non-neutropenic paediatric patients. J Antimicrob Chemother. 1988; 21:113–116.
26. Möller JC, Nelskamp I, Jensen R, Reiss I, Kohl M, Gatermann S, et al. Comparison of vancomycin and teicoplanin for prophylaxis of sepsis with coagulase negative staphylococci (CONS) in very low birth weight (VLBW) infants. J Perinat Med. 1997; 25(4):361–367. PMID: 9350607.
Article
27. Sánchez A, López-Herce J, Cueto E, Carrillo A, Moral R. Teicoplanin pharmacokinetics in critically ill paediatric patients. J Antimicrob Chemother. 1999; 44(3):407–409. PMID: 10511412.
28. Strenger V, Hofer N, Rödl S, Hönigl M, Raggam R, Seidel MG, et al. Age- and gender-related differences in teicoplanin levels in paediatric patients. J Antimicrob Chemother. 2013; 68(10):2318–2323. PMID: 23702837.
Article
29. Sun D, Zhang T, Mi J, Dong Y, Liu Y, Zhang Y, et al. Therapeutic drug monitoring and nephrotoxicity of teicoplanin therapy in Chinese children: a retrospective study. Infect Drug Resist. 2020; 13:4105–4113. PMID: 33209040.
30. Yamada T, Kubota T, Nakamura M, Ochiai M, Yonezawa M, Yano T, et al. Evaluation of teicoplanin concentrations and safety analysis in neonates. Int J Antimicrob Agents. 2014; 44(5):458–462. PMID: 25218156.
31. Yamada T, Kubota T, Yonezawa M, Nishio H, Kanno S, Yano T, et al. Evaluation of teicoplanin trough values after the recommended loading dose in children with associated safety analysis. Pediatr Infect Dis J. 2017; 36(4):398–400. PMID: 27977550.
Article
32. Zhang T, Sun D, Shu Z, Duan Z, Liu Y, Du Q, et al. Population pharmacokinetics and model-based dosing optimization of teicoplanin in pediatric patients. Front Pharmacol. 2020; 11:594562. PMID: 33363469.
Article
33. Zhao W, Zhang D, Storme T, Baruchel A, Declèves X, Jacqz-Aigrain E. Population pharmacokinetics and dosing optimization of teicoplanin in children with malignant haematological disease. Br J Clin Pharmacol. 2015; 80(5):1197–1207. PMID: 26138279.
Article
34. Kim SW. Therapeutic drug monitoring (TDM) of antimicrobial agents. Infect Chemother. 2008; 40(3):133–139.
Article
35. Hogan PG, Mork RL, Thompson RM, Muenks CE, Boyle MG, Sullivan ML, et al. Environmental methicillin-resistant Staphylococcus aureus contamination, persistent colonization, and subsequent skin and soft tissue infection. JAMA Pediatr. 2020; 174(6):552–562. PMID: 32227144.
Article
36. Inagaki K, Lucar J, Blackshear C, Hobbs CV. Methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia: nationwide estimates of 30-day readmission, in-hospital mortality, length of stay, and cost in the United States. Clin Infect Dis. 2019; 69(12):2112–2118. PMID: 30753447.
37. Laupland KB. Incidence of bloodstream infection: a review of population-based studies. Clin Microbiol Infect. 2013; 19(6):492–500. PMID: 23398633.
Article
38. Pereira MR, Rana MM. AST ID Community of Practice. Methicillin-resistant Staphylococcus aureus in solid organ transplantation-guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019; 33(9):e13611. PMID: 31120612.
Article
39. Guthrie JL, Teatero S, Hirai S, Fortuna A, Rosen D, Mallo GV, et al. Genomic epidemiology of invasive methicillin-resistant Staphylococcus aureus infections among hospitalized individuals in Ontario, Canada. J Infect Dis. 2020; 222(12):2071–2081. PMID: 32432674.
Article
40. Abebe W, Tegene B, Feleke T, Sharew B. Bacterial bloodstream infections and their antimicrobial susceptibility patterns in children and adults in Ethiopia: a 6-year retrospective study. Clin Lab. 2021; 67(11):
Article
41. Fu P, Xu H, Jing C, Deng J, Wang H, Hua C, et al. bacterial epidemiology and antimicrobial resistance profiles in children reported by the ISPED program in China, 2016 to 2020. Microbiol Spectr. 2021; 9(3):e0028321. PMID: 34730410.
Article
42. EMC. Targocid 200 mg powder for solution for injection/infusion or oral solution. Updated 2022. Accessed December 28, 2022. https://www.medicines.org.uk/emc/product/2926/smpc .
44. Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the infectious diseases society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011; 52(3):285–292. PMID: 21217178.
Article
45. Avedissian SN, Le J, Neely MN, Cortés-Penfield N, Bradley J, Rybak MJ, et al. Comment on: AUCs and 123s: a critical appraisal of vancomycin therapeutic drug monitoring in paediatrics. J Antimicrob Chemother. 2021; 76(9):2486–2488. PMID: 34021756.
Article
46. Dalton BR, Stewart JJ, Dersch-Mills D, Gin A, Dresser LD, Jorgensen SC. AUCs and 123s: a critical appraisal of vancomycin therapeutic drug monitoring in paediatrics-authors’ response. J Antimicrob Chemother. 2021; 76(9):2488–2489. PMID: 34245275.
Article
47. Jorgensen SC, Spellberg B, Shorr AF, Wright WF. Should therapeutic drug monitoring based on the vancomycin area under the concentration-time curve be standard for serious methicillin-resistant Staphylococcus aureus infections?-no. Clin Infect Dis. 2021; 72(9):1502–1506. PMID: 33740050.
Article
48. Murphy ME, Tang Girdwood S, Goldman JL, Scheetz MH, Downes KJ. Precision dosing of vancomycin: in defence of AUC-guided therapy in children. J Antimicrob Chemother. 2021; 76(10):2494–2497. PMID: 34096598.
Article
49. Hanai Y, Takahashi Y, Niwa T, Mayumi T, Hamada Y, Kimura T, et al. Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. J Antimicrob Chemother. 2022; 77(4):869–879. PMID: 35022752.
Article
50. Ueda T, Takesue Y, Nakajima K, Ichiki K, Doita A, Wada Y, et al. Enhanced loading regimen of teicoplanin is necessary to achieve therapeutic pharmacokinetics levels for the improvement of clinical outcomes in patients with renal dysfunction. Eur J Clin Microbiol Infect Dis. 2016; 35(9):1501–1509. PMID: 27278654.
Article
51. Ueda T, Takesue Y, Nakajima K, Ichiki K, Ishikawa K, Takai Y, et al. Clinical efficacy and safety in patients treated with teicoplanin with a target trough concentration of 20 μg/mL using a regimen of 12 mg/kg for five doses within the initial 3 days. BMC Pharmacol Toxicol. 2020; 21(1):50. PMID: 32641110.
Article
52. Matthews PC, Chue AL, Wyllie D, Barnett A, Isinkaye T, Jefferies L, et al. Increased teicoplanin doses are associated with improved serum levels but not drug toxicity. J Infect. 2014; 68(1):43–49. PMID: 24012820.
Article
53. Seki M, Yabuno K, Miyawaki K, Miwa Y, Tomono K. Loading regimen required to rapidly achieve therapeutic trough plasma concentration of teicoplanin and evaluation of clinical features. Clin Pharmacol. 2012; 4:71–75. PMID: 23236257.
Article
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr