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Factors Affecting the Initial Serum Concentration of Teicoplanin in Pediatric Patients: A Single-Center Retrospective

Tatsuo Kataoka1,2, Takanori Taogoshi1,2, Yoko Hiyama1,3

  • 1Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Japan.

Journal of the Pediatric Infectious Diseases Society
|August 8, 2026
PubMed

Insights

Higher teicoplanin loading doses are safe for pediatric patients. Clinical factors like febrile neutropenia and bone marrow transplant influence teicoplanin levels, requiring personalized dosing strategies.

Area of Science:

  • Pharmacology
  • Pediatric Infectious Diseases
  • Antibiotic Therapy

Background:

  • Teicoplanin (TEIC) treats serious gram-positive bacterial infections, including MRSA.
  • Current guidelines suggest higher TEIC trough concentrations, necessitating higher loading doses (LD).
  • Factors influencing TEIC Ctrough and safety of high-LD regimens in pediatrics are not fully understood.

Purpose of the Study:

  • Investigate factors influencing TEIC loading dose (LD) regimens in pediatric patients.
  • Assess the safety and efficacy of higher TEIC LDs in this population.

Main Methods:

  • Retrospective analysis of 108 pediatric patients (1-14 years) with TEIC concentrations.
  • Examined factors affecting initial Ctrough and Ctrough/Dose ratio (C/D).
  • Safety evaluated via serious adverse reactions at initial Ctrough measurement.

Main Results:

  • 52% of patients receiving higher LD (avg. 54.2 mg/kg/3 days) did not reach target Ctrough (15 μg/mL).
  • Initial Ctrough associated with age, eGFR, and serum albumin.
  • C/D ratio linked to eGFR and febrile neutropenia (FN); BMT further impacted C/D in FN patients.

Conclusions:

  • Clinical conditions like FN and BMT, affecting eGFR, influence pediatric TEIC Ctrough.
  • Higher TEIC loading doses were well-tolerated in pediatric patients.
  • Individualized LD determination considering clinical status is crucial for optimal TEIC therapy.
Abstract

Keywords:
loading dosepediatricteicoplanintherapeutic drug monitoring

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