救命救急医療におけるテイコプラ二ン(TEIC)高用量投与設計法の検討

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We analyzed the clinical efficacy and safety of treating MRSA infections with high-dose teicoplanin (TEIC) (800 mg×2 on the first day and 800 mg/day on the following 6 days) and devised a method of predicting serum trough concentrations on the 8th day of administration. Serum trough concentrations were obtained on the 1st day (day 1 ; D1), 2nd day (day 2 ; D2), 4th day (day 4 ; D4) and 24 hrs after the 7th day of administering TEIC (day 8 ; D8). We also compared the predicted D8 trough concentrations, based on those at D2, D4 and D2 and 4 using a Bayesian method based on the population pharmacokinetic parameters in TEICTDM Ver.2.0, with the actually measured trough concentrations on D8. The results were as follows : 1) The trough concentrations of TEIC on D2, D4 and D8 were 17.1±6.0, 18.0±6.3 and 20.8±7.1(mean±SD)μg/mL, respectively ; 2) High-dose treatment with TEIC achieved the effective serum trough concentration (15μg/mL) on day 2, and this treatment method demonstrated clinical and bacteriological efficacy and safety ; 3) Predicted concentrations on D8 calculated from either D2 or D4 levels were 75% and 35% higher than the observed values (p<0.001), respectively, but there was no significant difference when predicted concentrations at D8 were calculated from both D2and 4. In the present study on treatment with high-dose TEIC, when the Bayesian method was applied, a single sampling point produced low-reliability pharmacokinetic values with large prediction errors, while the use of two sampling points made it possible to predict trough levels with considerable precision.
日本医療薬学会の論文
2008-07-10

救命救急医療におけるテイコプラ二ン(TEIC)高用量投与設計法の検討

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