Objective: The objective of this study was to identify the factors influencing trough teicoplanin concentrations (C(min)), to investigate the relationship between teicoplanin C(min) with efficacy and safety, and to determine a target therapeutic concentration.
Methods: An analysis was performed on 95 serum concentrations from 50 patients with gram-positive infections who received teicoplanin treatment. Teicoplanin serum concentrations were measured by high-performance liquid chromatography. Univariate and multivariable analysis were performed to investigate the effect of independent variables on teicoplanin C(min). A logistic regression analysis was used to determine the relationship between teicoplanin C(min) and efficacy and safety.
Results: Teicoplanin therapy was effective in 74.0% (37/50) of patients, and 10.0% (5/50) of patients exhibited signs of adverse events. Using multivariable linear regression, two covariates were found to be a significant effect on teicoplanin C(min): dosage (mg/kg), and creatinine clearance rate (CL(cr). There was no covariate that has a significant impact on the safety of teicoplanin and only teicoplanin C(min) has a significant impact on the efficacy of treatment in the logistics regression. The logistics regression analysis showed that teicoplanin C(min) of 10 mg/L was associated with a 79.4% probability of success response.
Conclusions: This study highlighted that teicoplanin C(min) was strongly influenced by the values of dosage (mg/kg) and CL(cr) and the teicoplanin C(min) range of 10 - 20 mg/L was identified as the therapeutic target with optimum clinical efficacy and safety.