Teicoplanin

What it is and how it works

Teicoplanin binds to the D-alanyl-D-alanine terminus of peptidoglycan precursors, inhibiting cell-wall synthesis in Gram-positive bacteria. It is active against staphylococci (including meticillin-resistant strains), streptococci, enterococci and Gram-positive anaerobes such as Clostridioides difficile. Its long half-life permits once-daily maintenance dosing.

Indications

Serious Gram-positive infections, including complicated skin and soft-tissue, bone and joint infections, pneumonia, complicated urinary tract infections, infective endocarditis and bacteraemia, peritonitis associated with peritoneal dialysis; orally (injection solution) for Clostridioides difficile–associated diarrhoea.

Dosage and administration (summary)

Given by intravenous or intramuscular injection or intravenous infusion: loading doses of about 6–12 mg/kg every 12 hours for 3–5 doses, followed by maintenance doses of 6–12 mg/kg once daily, depending on the infection; dose adjusted in renal impairment after the loading phase and guided by trough concentrations.

Contraindications

Hypersensitivity to teicoplanin.

Warnings and precautions

Use with caution in patients hypersensitive to vancomycin because of possible cross-sensitivity. Monitor renal and auditory function and blood counts during prolonged therapy or when co-administered with nephrotoxic or ototoxic drugs. Infusion-related reactions, including red man syndrome, are less frequent than with vancomycin.

Pregnancy

Use in pregnancy only if clearly necessary, owing to limited data and a potential risk of fetal oto- and nephrotoxicity.

Storage and supply

Store the powder below 25 °C; reconstituted solution should be used promptly or stored refrigerated for the period stated by the manufacturer.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.