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

作者：Shiohira Hideo^*; Nakamatsu Masashi; Kise Yuya; Higa Futoshi; Tateyama Masao; Hokama Nobuo; Kuniyoshi Yukio; Ueda Shinichiro; Nakamura Katsunori; Fujita Jiro

来源：Journal of the Pharmaceutical Society of Japan, 2016, 136(9): 1313-1317.

DOI：10.1248/yakushi.15-00296

• teicoplanin
• therapeutic drug monitoring
• renal impairment
• methicillin-resistant Staphylococcus aureus
• bacteremia

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 mu g/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.

• 出版日期2016-9