Abstract
Objectives: We performed a prospective study to investigate an optimal loading dose regimen of teicoplanin (TEIC) that aimed to generate therapeutic trough levels within 48 hours. Methods: ICU patients with proven or suspected methicillin-resistant Staphylococcus aureus (MRSA) infection were prospectively enrolled. Based on body weight and creatinine clearance (CrCl), a TEIC loading dose was chosen using nomogram to reach the therapeutic trough level (15μg/ml) within 48 hours. Patients received an adjusted dose of TEIC every 12 hours on day 1, 2, and once a day thereafter. Serum TEIC level at 48 hours after the first administration was recorded as the initial trough level. Results: 73 patients were enrolled. The mean of TEIC initial loading dose was 472.6±11.4 mg (8.2 mg/kg) and the mean of total loading dose was 1,890±251.8 mg. The mean trough level at 48 hours was 17.1±5.8μg/ml. No nephrotoxicity or other severe adverse effects were observed. Conclusions: Following the nomogram, we could easily decide the loading dose and the target TEIC trough level could be reached within 48 hours without evidence of severe adverse effects.
