Teicoplanin

Indications & Dose:

Severe infections caused by gram positive bacteria (especially staph. aureus). Prophylaxis against gram positive endocarditis in dental surgery to high risk heart patients. Intraperitoneal adminis-tration to treat peritonitis in patients undergoing chronic ambulatory peritoneal dialysis.

 DOSE

Intravenously or intramuscularly. Therapeutics dose

Adult and elderly patients with normal renal function: Moderate infections: Loading dose one single i.v. injection of 400mg on the first day. Maintenance a single i.v. or i.m. injection of 200mg daily

- Severe infections: Loading dose 400mg i.v. injection, every 12 hours for the first 3 doses.
Maintenance a single i.v. or i.m. injection of 400mg daily, over 85 kg body weight 3-6 mg/kg Reduce dose from fourth day in renal insufficiency. . In some clinical situations, such as infected severely burned patients or Staphylococcus aureus endocarditis, unit maintenance doses of up to 12mg/kg may be required.

Prophylaxis in orthopaedic surgery: 400 mg i.v as a single dose at induction of anaesthesia

Contraindications:

 Hypersensitivity to glycopeptide antibiotics. 

Children

Neonates: 16 mg/kg body weight as a single dose by i.v infusion over 30 minutes on 1st day than 8mg/kg body weight as a single dose daily.

Over 2 months: Moderate infection; 10mg /kg/body weight by i.v inj every 12 hour for 1st three doses than 6mg/kg body weight by i.v, i.m inj as a single dose daily. Severe infection: 10mg/kg body weight i.v inj every 12 hour for 1st three doses than 10mg/kg body weight by I.V or I.M inj as a single dose daily

Side Effects:

Pain, phlebitis, s.c. abscess at site of injection. Hypersensitivity reaction. Elevated liver enzymes. Transient increase in serum creatinine. Eosinophilia. Thrombocytopenia. Nausea, vomiting, diarrhoea. 

Cautions:

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Interaction:

Drugs

In clinical trials telcoplanin has been administered to many patients already receiving various medication including other antibiotics, antihypertensive anaesthetic agents, cardiac drugs, and antidiabetic agents without evidence of adverse interaction. In parti-cular, in patients treated with concomitant aminoglycosides there was no evidence of synergistic oto-or nephro-toxicity. Animal studies have shown lack of interaction with diazepam, thiopentone, morphine, neuro-muscular blocking agents or halothane. 

Warnings:

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Counselling:

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