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Comparison of vancomycin and teicoplanin trough serum levels in patients treated for orthopaedic device infections

Abstract number: R2268

Lemaire X., Legout L., Migaud H., Loiez C., Yazdanpanah Y., Senneville E.

Introduction: no study has compared the pharmacokinetic performances of the glycopeptide agents vancomycin (V) and teicoplanin (T) for the treatment of pts with orthopaedic device infections (ODI).

Objectives: to compare trough serum concentrations of V and T in patients (pts) treated for with both loading doses and high daily dosages for ODI.

Methods: medical charts for pts treated with either V or T for ODI and for which the results of at least 2 trough levels were available were reviewed. Patients with V or T therapy were compared on the following parameters: age, weight, renal clearance, protides, fever, white blood cells, CRP level, and trough serum levels of V or T.

Results: 52 patients hospitalised from May 2000 to December 2005 were eligible for the study. Intravenous loading doses were administered in 26 pts treated with V (0.5–1g infused during 1 hour) and in 26 pts treated with T (10 mg/kg bid for 5 injections). Following the loading dose, one-daily10–12 mg/kg T infusion and continuous V infusion of 30 mg/kg were administered. No significant differences in the patients' demographic parameters were observed between T and V groups.

Trough levels performed at day at day 2±1 and at day 5 ±1 were significantly higher in T than in V patients (26.1 vs 16 mg/L, p = 0.01 and 27.8 vs 19.9 mg/L, p = 0.01, respectively). When considering an expected trough value of >25 mg/L, this target was reached at day 2+/1 in 1/26 V pts vs 10/26 T pts (p = 0.002), and at day 5 ±1 in 6/26 V pts vs 13/26 T pts (p = 0.04).

Conclusion: teicoplanin trough serum concentrations obtained during the first week of treatment are significantly higher than those of vancomycin in patients treated with both loading doses and high daily dosages for ODI.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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