Factors on trough teicoplanin levels, associations between levels, efficacy and safety in patients with gram-positive infections

Objective: The objective of this study was to identify the factors influencing trough teicoplanin concentrations (C_min), to investigate the relationship between teicoplanin C_min with efficacy and safety, and to determine a target therapeutic concentration. Methods: An analysis was performed on 95 serum concentrations from 50 patients with gram-positive infections who received teicoplanin treatment. Teicoplanin serum concentrations were measured by high-performance liquid chromatography. Univariate and multivariable analysis were performed to investigate the effect of independent variables on teicoplanin C_min. A logistic regression analysis was used to determine the relationship between teicoplanin C_min and efficacy and safety. Results: Teicoplanin therapy was effective in 74.0% (37/50) of patients, and 10.0% (5/50) of patients exhibited signs of adverse events. Using multivariable linear regression, two covariates were found to be a significant effect on teicoplanin C_min: dosage (mg/kg), and creatinine clearance rate (CL_cr). There was no covariate that has a significant impact on the safety of teicoplanin and only teicoplanin C_min has a significant impact on the efficacy of treatment in the logistics regression. The logistics regression analysis showed that teicoplanin C_min of 10 mg/L was associated with a 79.4% probability of success response. Conclusions: This study highlighted that teicoplanin C_min was strongly influenced by the values of dosage (mg/kg) and CL_cr and the teicoplanin C_min range of 10-20 mg/L was identified as the therapeutic target with optimum clinical efficacy and safety.