Long-term Treatment of Teicoplanin for Methicillin-resistant Staphylococcus aureus Sternal Osteomyelitis with Renal Impairment: A Case of High Teicoplanin Trough Levels Maintained by Therapeutic Drug Monitoring

Yakugaku Zasshi. 2016;136(9):1313-7. doi: 10.1248/yakushi.15-00296.

Abstract

Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic drug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment. Plasma teicoplanin trough levels were maintained at a high range (20-30 μg/mL). Although the patient required long-term teicoplanin treatment, a further decline in renal function was not observed, and blood culture remained negative after the start of treatment. Teicoplanin treatment that is maintained at a high trough level by therapeutic drug monitoring might be beneficial for severe methicillin-resistant Staphylococcus aureus infection accompanied by renal impairment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Drug Monitoring*
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Osteomyelitis / complications
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Postoperative Complications
  • Renal Insufficiency / complications*
  • Severity of Illness Index
  • Staphylococcal Infections*
  • Sternum*
  • Teicoplanin / administration & dosage*
  • Teicoplanin / blood
  • Time Factors
  • Treatment Outcome

Substances

  • Teicoplanin