Abstract
Although the loading dose (LD) for teicoplanin is required, the appropriate regimen is a matter of debate. This study estimated the LD by revising its central compartmental volume of distribution (Vc) in the population pharmacokinetic (PPK) parameter, which is frequently used for Japanese patients.
This was a retrospective study. Thirty-six patients who were administered teicoplanin and underwent serum trough level measurement within 48 hours were eligible. We compared the measured and predicted levels using the PPK parameters and estimated the mean prediction error (ME, μg/mL) and the mean absolute prediction error (MAE, μg/mL) for prediction. We revised the Vc value of the PPK parameter (10.4 L) to achieve the ME of 0, and denoted the revised Vc as rVc, which was then validated for other groups of patients by comparing measured and predicted steadystate serum trough levels (Css). We subsequently estimated the LD that can achieve a serum trough level between 15 and 30 μg/mL 48 hours after beginning administration.
The rVc was estimated to be 6.6 L, and the MAE was significantly decreased from 4.0 to 2.9 (P<0.05) by using rVc. We demonstrated that the rVc could also be used for predicting Css. The LD was estimated to be 600 mg q12h × 4 for 2-days loading and between 800 mg and 1000 mg q12h × 2 for 1-day loading.
This study estimated the LD for teicoplanin, demonstrating that it is useful to estimate individual LD based on PPK parameters.
