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<p>Management of teicoplanin (TEIC) therapy based on its free serum concentrations may be crucial for optimizing efficacy and safety. This study investigated the protein-binding variability of TEIC and evaluated predictive models for free TEIC concentrations in patients with various diseases. Additionally, effects of free serum TEIC concentrations on the efficacy and adverse event risk of TEIC therapy were analyzed. Free TEIC concentrations in sera from patients received TEIC treatment were determined via high-performance liquid chromatography followed by ultrafiltration. Therapeutic efficacy was evaluated by monitoring the changes in the serum C-reactive protein levels and fever, and adverse events were evaluated by examining the renal and hepatic functions. No significant correlation was observed between serum albumin concentration and free TEIC percentage; however, free TEIC percentage showed significant interpatient variability. Notably, predictive models based on the serum albumin and total serum TEIC concentrations were inaccurate for patients with different diseases. However, measured free serum TEIC concentrations predicted the therapeutic efficacy and the adverse event risk. In conclusion, our results suggest that TEIC dosage management based on the measured free serum TEIC concentrations, rather than the total or estimated TEIC concentrations, improves the clinical outcomes of patients with methicillin-resistant <i>Staphylococcus aureus</i> infections.</p>

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Evaluation of teicoplanin protein-binding variability and clinical utility of its free serum concentration measurement

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月27日

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  • Yoshitaka Inno,
  • Takanori Taogoshi,
  • Airi Matsumoto,
  • Tomoharu Yokooji,
  • Hiroaki Matsuo

摘要

Management of teicoplanin (TEIC) therapy based on its free serum concentrations may be crucial for optimizing efficacy and safety. This study investigated the protein-binding variability of TEIC and evaluated predictive models for free TEIC concentrations in patients with various diseases. Additionally, effects of free serum TEIC concentrations on the efficacy and adverse event risk of TEIC therapy were analyzed. Free TEIC concentrations in sera from patients received TEIC treatment were determined via high-performance liquid chromatography followed by ultrafiltration. Therapeutic efficacy was evaluated by monitoring the changes in the serum C-reactive protein levels and fever, and adverse events were evaluated by examining the renal and hepatic functions. No significant correlation was observed between serum albumin concentration and free TEIC percentage; however, free TEIC percentage showed significant interpatient variability. Notably, predictive models based on the serum albumin and total serum TEIC concentrations were inaccurate for patients with different diseases. However, measured free serum TEIC concentrations predicted the therapeutic efficacy and the adverse event risk. In conclusion, our results suggest that TEIC dosage management based on the measured free serum TEIC concentrations, rather than the total or estimated TEIC concentrations, improves the clinical outcomes of patients with methicillin-resistant Staphylococcus aureus infections.