抄録
We analyzed the clinical efficacy and safety of treating MRSA infections with high-dose teicoplanin (TEIC) (800 mg×2 on the first day and 800 mg/day on the following 6 days) and devised a method of predicting serum trough concentrations on the 8th day of administration.Serum trough concentrations were obtained on the 1st day (day 1 ; D1),2nd day (day 2 ; D2),4th day (day 4 ; D4)and 24 hrs after the 7th day of administering TEIC (day 8 ; D8).We also compared the predicted D8 trough concentrations,based on those at D2,D4 and D2 and 4 using a Bayesian method based on the population pharmacokinetic parameters in TEICTDM Ver.2.0,with the actually measured trough concentrations on D8.
The results were as follows : 1)The trough concentrations of TEIC on D2,D4 and D8 were 17.1±6.0,18.0±6.3 and 20.8±7.1(mean±SD)μg/mL,respectively ; 2)High-dose treatment with TEIC achieved the effective serum trough concentration (15μg/mL) on day 2,and this treatment method demonstrated clinical and bacteriological efficacy and safety ; 3)Predicted concentrations on D8 calculated from either D2 or D4 levels were 75% and 35% higher than the observed values (p <0.001),respectively,but there was no significant difference when predicted concentrations at D8 were calculated from both D2 and 4.
In the present study on treatment with high-dose TEIC,when the Bayesian method was applied,a single sampling point produced low-reliability pharmacokinetic values with large prediction errors,while the use of two sampling points made it possible to predict trough levels with considerable precision.
