Clinical use
Monitoring of teicoplanin levels.
Background
Teicoplanin is a glycopeptide which has antibiotic activity against aerobic and anaerobic Gram-positive bacteria, by interfering with peptidoglycan synthesis and thereby inhibiting cell wall biosynthesis. It can be used for the treatment of severe sepsis induced by Gram-positive infections, such as methicillin-resistant Staphylococcus aureus.
Teicoplanin is usually greater than 90% bound to protein and is mostly excreted in the urine. It has a relatively long duration of action and can be administered intravenously and intramuscularly. There are few reported cases of overdose and severe toxicity has not been observed, but as teicoplanin is often used in patients with several risk factors for acute kidney injury it may contribute to renal impairment in these cases. The need for monitoring is therefore to ensure that therapeutic concentrations are achieved, especially in patients who have not responded to therapy. A pre-dose (trough level) sample is recommended, the first measurement being performed on the fourth day of teicoplanin administration.
Reference ranges
10 – 60mg/L
Patient preparation
Pre-dose (trough level): taken before administration of next Teicoplanin dose
Specimen requirements
- Serum separating tube (SST) – Gold top tube
- or Lithium heparin – Green top tube
- or Plain – Red top tube
Turnaround time
6 hours
Analysing laboratory
Biochemistry Lab, James Cook University Hospital, Marton Road, TS4 3BW