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Published on: September 20, 2019
Impact of hypoalbuminemia severity on total teicoplanin concentrations after 3 days loading dose: a retrospective
Yuki Shimizu1, Kazuhiko Hanada2, Takeaki Watanabe1
1Department of Pharmacy, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan.
Background:
Hypoalbuminemia is known to decrease total teicoplanin (TEIC) concentration; however, whether total TEIC concentration varies depending on hypoalbuminemia severity remains unclear. This study investigated the correlation between hypoalbuminemia severity and total TEIC concentrations after 3 days loading dose.
Methods:
The study included patients (≥18 years old) administered TEIC between January 2017 and January 2025. Factors influencing total TEIC trough concentrations after 3 days loading dose (Ctrough) were determined using multiple linear regression. Serum albumin (Alb) levels were stratified into three groups. The total and predicted free TEIC Ctrough of patients administered standard and high loading dose regimens were compared among the groups.
Results:
The total TEIC Ctrough was negatively correlated with age (p = 0.04), and the estimated glomerular filtration rate (p < 0.01) and positively correlated with body weight (p < 0.01), serum Alb (p < 0.01), and TEIC loading dose for within 3 days (p < 0.01). The median total TEIC Ctrough for the three groups differed significantly in both dosing regimens: standard, 10.5 [interquartile range, 9.2-13.0], 15.8 [12.1-18.6], and 17.1 [15.4-20.6] μg/mL; high, 12.5 [9.4-16.8], 17.2 [15.7-18.4], and 20.7 [17.4-22.8] μg/mL for Alb <2.0 g/dL, 2.0 ≤ Alb <3.0 g/dL, and Alb ≥3.0 g/dL, respectively. However, the predicted free TEIC Ctrough was not significantly different among the Alb groups for either regimen.
Conclusion:
The more severe the hypoalbuminemia, the lower the total TEIC Ctrough; however, predicted free TEIC Ctrough might not be affected. Overall, setting lower target total TEIC concentrations may be beneficial in case of hypoalbuminemia.
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