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1 X 200 mg
Adult or elderly patients with normal renal function:
Moderate infections: Skin and soft tissue infection, urinary tract infection, lower respiratory tract infection.
Loading dose: One single IV or IM injection of 400 mg on the first day.
Maintenance dose: A single IV or IM injection of 200 mg daily.
Severe infections: Joint and bone infection, septicaemia, endocarditis.
Loading dose: Three 400 mg IV injections, administered 12 hours apart.
Maintenance dose: A single IV or IM injection of 400 mg daily.
1. Standard doses of 200 and 400 mg equate respectively to mean doses of 3 and 6 mg/kg. In patients weighing more than 85 kg it is recommended to adapt the dosage to the weight following the same therapeutic schedule: moderate
infection 3 mg/kg, severe infection 6 mg/kg.
2. In some clinical situations, such as infected, severely burned patients or Staphylococcus aureus endocarditis, unit maintenance doses of up to 12 mg/kg have been administered (intravenously). In endocarditis caused by Staphylococcus aureus, satisfactory results have been achieved with teicoplanin in polytherapy. When serum concentrations are controlled in severe infections, the trough levels must be 10 times higher than the MIC or, generally, at least 10 mg/l.
In the treatment of antibiotic-associated diarrhoea caused by Clostridium difficile: one oral dose of 200 mg twice a day.
Teicoplanin can be used to treat Gram-positive infections in children from the age of 2 months. For severe infections and neutropenic patients the recommended dose is 10 mg/kg every 12 hours for the first three doses; thereafter a dose of 10 mg/kg should be administered by either intravenous
or intramuscular injection as a single dose each day.
For moderate infections the recommended dose is 10 mg/kg every twelve hours for the first three doses; thereafter a dose of 6 mg/kg should be administered by either intravenous or intramuscular injection as a single dose each day.
The recommended dosage regimen for neonates is a loading dose of 16 mg/kg followed by a daily dose of 8 mg/kg. The IV dose must be infused over 30 minutes.
In continuous ambulatory periotoneal dialysis:
After a single loading IV dose of 400 mg if the patient is febrile, the recommended dosage is 20 mg/L per bag in the first week, 20 mg/L in alternate bags in the second week and 20 mg/L in the overnight dwell bag only during the
third week, feverish patients must also take an IV loading dose of 400 mg of teicoplanin.
Teicoplanin remains stable in solutions for peritoneal dialysis (1.36% or 3.86% dextrose). These solutions must not be kept for more than 24 hours.
It is recommended that the treatment be combined with an appropriate antibacterial agent when the infection requires a maximum antibacterial activity (e.g. staphylococcal endocarditis) and when it cannot be ruled out that there
is a mixed infection with gram-negatives (e.g. empirical treatment of fever in a neutropenic patient).
Adults and elderly patients with renal insufficiency:
For patients with impaired renal function, reduction of dosage is not required until the fourth day of Targocid treatment. Measurement of the serum concentration of teicoplanin may optimise therapy.
From the fourth day of treatment:
In mild renal insufficiency: Creatinine clearance between 40 and 60 ml/min, Targocid dose should be halved, either by administering the initial unit dose every two days, or by administering half of this dose once a day.
In severe renal insufficiency: Creatinine clearance less than 40 ml/min and in
haemodialysed patients, Targocid dose should be one third of the normal either by administering the initial unit dose every third day, or by administering one third of this dose once a day. Teicoplanin is not removed by dialysis.
Indicated in potentially serious Gram-positive infections including those which cannot be treated with other antimicrobial drugs, eg. penicillins and cephalosporins. This drug is useful in the therapy of serious staphylococcal infections in patients who cannot receive or who have failed to respond to the penicillins and cephalosporins, or who have infections with staphylococci resistant to other antibiotics. The effectiveness of teicoplanin has been documented in the following infections:
Skin and soft tissue infections, urinary tract infections, lower respiratory tract infections, joint and bone infections, septicaemia, endocarditis and peritonitis related to continuous ambulatory peritoneal dialysis.
Teicoplanin is contra-indicated in patients who have exhibited previous hypersensitivity to the drug.
Teicoplanin can cause dizziness and headaches. The ability to drive or use machines may be affected. Patients experiencing these undesirable effects should not drive or use machines. This drug should be administered with caution in patients known to be hypersensitive to vancomycin since cross hypersensitivity may occur. However, a history of the ?ed Man Syndrome?that can occur with vancomycin is not a contra-indication to Teicoplanin. Thrombocytopenia has been reported with teicoplanin, especially at higher doses than those usually recommended. It is advisable for periodic haematological studies to be performed during treatment. Liver and renal function tests are advised during treatment. Serial renal and auditory function tests should be undertaken in the following circumstances: Prolonged treatment in patients with renal insufficiency. Concurrent and sequential use of other drugs which may have neurotoxic and/or nephrotoxic properties. These include minoglycosides, colistin, amphotericin B, ciclosporin, cisplatin, furosemide and ethacrynic acid. However, there is no evidence of synergistic toxicity with combinations with Teicoplanin. Dosage must be adapted in patients with renal impairment . Superinfection: as with other antibiotics, the use of teicoplanin, especially if prolonged, may result in overgrowth of non-susceptible organisms. Repeated evaluation of the patient? condition is essential. If superinfection occurs during therapy, appropriate measures should be taken.
Erythema (redness), rash (skin rash), pruritus, pain, pyrexia (fever), Eosinophilia, thrombocytopenia, leucopenia, Anaphylactic reaction (anaphylaxis, Dizziness, headache, Deafness (mild hearing loss), tinnitus, vestibular disorder, Phlebitis, Bronchospasm, Nausea, vomiting, diarrhea, Transaminases abnormal (transient abnormality of transaminases), blood alkaline phosphatase abnormal (transient abnormality of alkaline phosphatase), blood creatinine increased (transient rise of serum creatinine).
This drug should be used with care in conjunction with or sequentially with other drugs with known nephrotoxic or ototoxic potential. These include aminoglycosides, amphotericin B, ciclosporin, and furosemide .Of particular concern are streptomycin, neomycin, kanamycin, gentamicin, amikacin, tobramycin, cephaloridine, colistin,
See prescribing information for full details.