Variation in protein binding ratio (PBR) of teicoplanin (TEIC) was investigated in continuous hemodiafiltration (CHDF) patients. TEIC is classified as a high PBR drug (≧90%), and it was reported that the PBR of TEIC decreased with an decrease in the serum albumin level in hypoalbuminemia patients. However, few reports can be found about the variation of PBR of TEIC for CHDF patient. An antibiotic activity is directly determined by the level of unbound antibiotics species (C
free) in the target site, namely, an increase in the C
free enhances the risks of TEIC as well as the therapeutic effect against Methicillin-resistant
Staphylococcus aureus (MRSA). In this study, both the total concentration (C
total) and C
free of TEIC were determined and the PBRs were compared between a patient with normal albumin level, hypoalbuminemia patients and CHDF patients. Similarly to the previous report, the lowering of PBR of TEIC was demonstrated in the hypoalbuminemia patients. On the other hand, the CHDF patients showed lower value of PBR suggesting some change in the protein binding ability, although showed higher values of serum albumin level in comparison with the hypoalbuminemia patients. It was not necessary to measure the C
free value for the hypoalbuminemia patient routinely, but the monitoring of C
free as well as C
total for the CHDF patients can be important for the proper TEIC use because of the potential specialty of PBR.
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