Limits...
Teicoplanin dosing strategy for treatment of Staphylococcus aureus in Korean patients with neutropenic fever.

Ahn BJ, Yim DS, Lee DG, Kwon JC, Kim SH, Choi SM - Yonsei Med. J. (2011)

Bottom Line: The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC24/MIC>125 [or 345] using logistic analysis.The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever.To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.

ABSTRACT

Purpose: The present study was conducted to determine and compare the target attainment rate (TAR) between microorganism-nonspecific (C(trough)) and microorganism- specific (AUC24/MIC) targets over two weeks of teicoplanin administration according to several dose regimens for the treatment of Staphylococcus aureus in Korean patients with neutropenic fever.

Materials and methods: One thousand virtual concentrations were obtained for each dose using the population pharmacokinetic parameters of teicoplanin adopted from a published study. Simulation of 1,000 virtual MICs was performed using the MICs of 78 clinical isolates of S. aureus collected from a hospital in Korea. Thereafter, these simulated MICs were randomly allocated to 1,000 virtual patients in whom the TARs for AUC24/MIC>125 [or 345] and C(trough)>10 [or 20] mg/L were determined. The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC24/MIC>125 [or 345] using logistic analysis.

Results: The standard dose regimen of teicoplanin showed TARs of about 70% [or 33%] and 70% [or 20%] at steady-state in cases with AUC24/MIC>125 [or 345] and C(trough)>10 [or 20] mg/L, respectively.

Conclusion: The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever. To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.

Show MeSH

Related in: MedlinePlus

Summarized study flow to determine the dose-response relationship of teicoplanin against S. aureus in febrile neutropenic Korean patients. PK, pharmacokinetic; AUC, area under the curve; MIC, minimum inhibitory concentration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3104459&req=5

Figure 1: Summarized study flow to determine the dose-response relationship of teicoplanin against S. aureus in febrile neutropenic Korean patients. PK, pharmacokinetic; AUC, area under the curve; MIC, minimum inhibitory concentration.

Mentions: With this information the dose - response (TAR) relationships could be predicted. Fig. 1 summarizes the main steps taken in the present study to elucidate the dose-response relationships of teicoplanin against Staphylococcus aureus in Korean patients with neutropenic fever.


Teicoplanin dosing strategy for treatment of Staphylococcus aureus in Korean patients with neutropenic fever.

Ahn BJ, Yim DS, Lee DG, Kwon JC, Kim SH, Choi SM - Yonsei Med. J. (2011)

Summarized study flow to determine the dose-response relationship of teicoplanin against S. aureus in febrile neutropenic Korean patients. PK, pharmacokinetic; AUC, area under the curve; MIC, minimum inhibitory concentration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104459&req=5

Figure 1: Summarized study flow to determine the dose-response relationship of teicoplanin against S. aureus in febrile neutropenic Korean patients. PK, pharmacokinetic; AUC, area under the curve; MIC, minimum inhibitory concentration.
Mentions: With this information the dose - response (TAR) relationships could be predicted. Fig. 1 summarizes the main steps taken in the present study to elucidate the dose-response relationships of teicoplanin against Staphylococcus aureus in Korean patients with neutropenic fever.

Bottom Line: The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC24/MIC>125 [or 345] using logistic analysis.The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever.To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.

ABSTRACT

Purpose: The present study was conducted to determine and compare the target attainment rate (TAR) between microorganism-nonspecific (C(trough)) and microorganism- specific (AUC24/MIC) targets over two weeks of teicoplanin administration according to several dose regimens for the treatment of Staphylococcus aureus in Korean patients with neutropenic fever.

Materials and methods: One thousand virtual concentrations were obtained for each dose using the population pharmacokinetic parameters of teicoplanin adopted from a published study. Simulation of 1,000 virtual MICs was performed using the MICs of 78 clinical isolates of S. aureus collected from a hospital in Korea. Thereafter, these simulated MICs were randomly allocated to 1,000 virtual patients in whom the TARs for AUC24/MIC>125 [or 345] and C(trough)>10 [or 20] mg/L were determined. The relationship of the maintenance dose with the steady-state TAR was predicted with respect to the AUC24/MIC>125 [or 345] using logistic analysis.

Results: The standard dose regimen of teicoplanin showed TARs of about 70% [or 33%] and 70% [or 20%] at steady-state in cases with AUC24/MIC>125 [or 345] and C(trough)>10 [or 20] mg/L, respectively.

Conclusion: The current standard dose regimen was predicted to be insufficient to adequately treat S. aureus in Korean patients with neutropenic fever. To assure at least an 80% TAR in this population, dose adjustment of teicoplanin should be considered.

Show MeSH
Related in: MedlinePlus