Tolerability and Plasma Drug Level Monitoring of Prolonged Subcutaneous Teicoplanin Treatment for Bone and Joint Infections

• Published in: Antimicrobial agents and chemotherapy Vol. 60; no. 10; pp. 6365 - 6368
• Main Authors: El Samad, Youssef, Lanoix, Jean-Philippe, Bennis, Youssef, Diouf, Momar, Saroufim, Carlo, Brunschweiler, Benoit, Rousseau, Florence, Joseph, Cédric, Hamdad, Farida, Ait Amer Meziane, Mohamed, Routier, Simon, Schmit, Jean-Luc
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01-10-2016
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - blood; Anti-Bacterial Agents - therapeutic use; Bone Diseases, Infectious - drug therapy; Bone Diseases, Infectious - microbiology; Clinical Therapeutics; Drug Monitoring; Female; Gram-Positive Bacterial Infections; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Cocci - pathogenicity; Humans; Injections, Subcutaneous; Joint Diseases - drug therapy; Joint Diseases - microbiology; Life Sciences; Male; Middle Aged; Prospective Studies; Teicoplanin; Teicoplanin - administration & dosage; Teicoplanin - blood; Teicoplanin - therapeutic use
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.00351-16

Teicoplanin is a key drug for the treatment of multiresistant staphylococcal bone and joint infections (BJI), yet can only be administered via a parenteral route. The objective of this study was to evaluate the safety and tolerability of subcutaneous (s.c.) teicoplanin for that indication over 42 days. Thirty patients with Gram-positive cocci BJI were included. Once the target of 25 to 40 mg/liter trough serum concentration was achieved, treatment was switched from an intravenous to an s.c. route. No discontinuation of teicoplanin related to injection site reaction and no severe local adverse event were observed. On multivariate analysis, better tolerability was observed at the beginning of treatment, in patients over 70 years old, and for dosages less than 600 mg. In conclusion, we recommend s.c. administration of teicoplanin when needed.