Infection and Drug Resistance (Nov 2020)

Therapeutic Drug Monitoring and Nephrotoxicity of Teicoplanin Therapy in Chinese Children: A Retrospective Study

  • Sun D,
  • Zhang T,
  • Mi J,
  • Dong Y,
  • Liu Y,
  • Zhang Y,
  • Zhang D,
  • Wang T,
  • Cheng H,
  • Dong Y

Journal volume & issue
Vol. Volume 13
pp. 4105 – 4113

Abstract

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Dan Sun,1,* Tao Zhang,1,* Jie Mi,2 Yuzhu Dong,3 Yang Liu,1 Ying Zhang,1 Di Zhang,1 Taotao Wang,1 Hua Cheng,2 Yalin Dong1 1Department of Pharmacy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China; 2Department of Pharmacy, Xi’an Children’s Hospital, Xi’an, Shaanxi 710003, People’s Republic of China; 3Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yalin DongDepartment of Pharmacy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of ChinaTel/ Fax +86-29-85323241Email [email protected] ChengDepartment of Pharmacy, Xi’an Children’s Hospital, Xi’an, Shaanxi 710003, People’s Republic of ChinaTel/ Fax +86-29-87692090Email [email protected]: This study aims to 1) describe the distribution characteristics of teicoplanin trough concentration (Cmin) and explore the related influencing factors and 2) evaluate the nephrotoxicity of teicoplanin in children.Patients and Methods: A cohort of children who were treated with teicoplanin intravenously were included in this retrospective study. Regression analysis was performed to explore the factors associated with the fluctuations of teicoplanin Cmin and the development of nephrotoxicity. Classification and regression tree analysis was used to identify the population at high risk for teicoplanin nephrotoxicity.Results: A total of 269 plasma samples from 186 children were collected. Underexposure (Cmin < 10 mg/L) was documented in 52.7% of cases. The Cmin/dose after administering the loading dose was strongly associated with age (P = 0.008), weight (P = 0.039), and serum creatinine (P = 0.022). The Cmin/dose after administering the maintenance dose was strongly associated with gender (P = 0.014) and serum creatinine (P = 0.006). Cmin (P = 0.012) and the concomitant treatment with amphotericin B (P = 0.001) were the independent risk factors for teicoplanin-related nephrotoxicity. Children who were concomitantly treated by amphotericin B with teicoplanin Cmin > 9.81 mg/L or patients with teicoplanin Cmin > 21.94 mg/L were at high risk for nephrotoxicity.Conclusion: The fluctuations of teicoplanin Cmin could be affected by age, weight, gender, and serum creatinine. Cmin and concomitant treatment with amphotericin B were the independent risk factors for nephrotoxicity. We suggested that the therapeutic drug monitoring of teicoplanin should be performed in children.Keywords: teicoplanin, trough concentration, children, nephrotoxicity, factor

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