Optimal trough concentration of teicoplanin for the treatment of methicillin‐resistant Staphylococcus aureus infection: A systematic review and meta‐analysis.
What is known and objective: It has been recommended that the trough concentration (Cmin) of teicoplanin should be maintained at ≥20 μg/ml for difficult‐to‐treat complicated infections caused by methicillin‐resistant Staphylococcus aureus (MRSA). Conversely, Cmin of teicoplanin of at least 10 μg/ml...
| Published in: | Journal of Clinical Pharmacy & Therapeutics Vol. 46; no. 3; pp. 622 - 633 |
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| Main Authors: | , , , , , , , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jun2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150539927&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150539927 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02694727 EV4 jtl: Journal of Clinical Pharmacy & Therapeutics issn: 02694727 maglogo: Y pubinfo: dt: Jun2021 vid: 46 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 150539927 148512688 150539927 150539927 10.1111/jcpt.13366 150539927 ppf: 622 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Optimal trough concentration of teicoplanin for the treatment of methicillin‐resistant Staphylococcus aureus infection: A systematic review and meta‐analysis. aug: au: Hanai, Yuki Takahashi, Yoshiko Niwa, Takashi Mayumi, Toshihiko Hamada, Yukihiro Kimura, Toshimi Matsumoto, Kazuaki Fujii, Satoshi Takesue, Yoshio affil: Department of Pharmacy, Toho University Omori Medical Center, Tokyo, Japan sug: subj: Peptides Blood Antibiotics Blood Peptides Therapeutic Use Antibiotics Therapeutic Use Methicillin-Resistant Staphylococcus Aureus Staphylococcal Infections Drug Therapy Drug Efficacy Evaluation Peptides Adverse Effects Antibiotics Adverse Effects Drug Monitoring Methods Human Systematic Review Meta Analysis PubMed Staphylococcal Infections Mortality Hepatotoxicity Nephrotoxicity Descriptive Statistics Odds Ratio Confidence Intervals Dose-Response Relationship, Drug Risk Assessment Peptides Administration and Dosage Antibiotics Administration and Dosage ab: What is known and objective: It has been recommended that the trough concentration (Cmin) of teicoplanin should be maintained at ≥20 μg/ml for difficult‐to‐treat complicated infections caused by methicillin‐resistant Staphylococcus aureus (MRSA). Conversely, Cmin of teicoplanin of at least 10 μg/ml is required for non‐complicated MRSA infections. Considering the low incidence of nephrotoxicity for teicoplanin, Cmin = 15–30 μg/ml has been suggested for most MRSA infections. Thus, we assessed the clinical efficacy and adverse effects of teicoplanin at this target Cmin. Methods: We searched electronic databases (PubMed, Cochrane Central Register of Controlled Trials and Ichushi‐Web) to identify eligible studies. Studies were included if they provided the incidence of treatment success, mortality in patients with MRSA infection, and/or hepatotoxicity and nephrotoxicity according to the Cmin range. Results and discussion: Four trials assessing clinical success (n = 299) and three studies assessing adverse effects (n = 546) were included. Cmin = 15–30 μg/ml significantly increased the probability of treatment success compared with Cmin < 15 μg/ml (odds ratio [OR] = 2.68, 95% confidence interval [CI] = 1.14–6.32, p = 0.02). The all‐cause mortality rate did not differ between the groups (OR = 0.46, 95% CI = 0.13–1.61, p = 0.22). Cmin = 15–30 μg/ml did not increase the risks of nephrotoxicity (OR = 0.91, 95% CI = 0.49–1.69, p = 0.76) or hepatotoxicity (OR = 0.67, 95% CI = 0.18–2.44, p = 0.54). What is new and conclusion: Teicoplanin therapy using a Cmin target of 15–30 μg/ml is likely to be associated with better clinical responses than Cmin < 15 μg/ml without increasing the risk of adverse effects. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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