Active against Aerobic and Anaerobic gram-positive bacteria including Multi resistant Staphylococcus aureus (MRSA) though signs of increasing resistance
- Monitor levels closely in certain groups
- Alternative to Vancomycin
Action
- Glycopeptide antibiotics, Bactericidal activity
Indications
- Serious Gram-positive Infections, Infective endocarditis
- Dialysis associated peritonitis, Staphylococcal aureus infections
- Active against MRSA
Dose
- Teicoplanin 400 mg IM/IV/IV infusion every 12 hours for 1-3 doses then 200 mg OD
- Trough concentration should be 10-60 mg/L [15-60 mg/L with endocarditis]
- C. difficile infection: Teicoplanin 100-200 mg 12 h PO 10-14 days.
- MRSA, severe burns:Teicoplanin wt <70 kg give 400 mg 12-hrly for 3 doses then 400 mg OD. Wt >70 kg 6 mg/kg for 3 doses then 6 mg/kg OD.
- Severe infections, endocarditis: Teicoplanin 10 mg/kg 12-hrly for 3-5 doses then 10 mg/kg OD.
- Bone/joint infections: Teicoplanin 12 mg/kg 12-hrly for 3-5 doses then 12 mg/kg OD
Interactions
- Added ototoxicity with other ototoxic drugs
- Added nephrotoxicity. See BNF/Datasheet
Cautions
- Renal impairment, Elderly
- Monitor Teicoplanin levels and renal function if severe burns, or sepsis or deep staphylococcal infection, endocarditis, renal failure and elderly
Contraindications
- Nephrotoxic and ototoxic. Monitor hearing and LFT/U&E.
- Caution with other ototoxic/nephrotoxic drugs
- Vancomycin sensitivity
Side effects
- Nausea, Vomiting, Diarrhoea
- Eosinophilia leucopenia, neutropenia, thrombocytopenia
- Ototoxic (Vestibular disorders), Nephrotoxic
References