Exploring the results and influencing factors of minimum concentration of teicoplanin in elderly population
AIM To explore the influencing factors of achieving target teicoplanin trough concentrations(cmin)in elderly patients by monitoring their cmin levels,providing reference for the rational use of teicoplanin in elderly patients.METHODS A retrospective analysis was performed on elderly patients who were treated with teicoplanin,and serum concentration of teicoplanin was monitored from November 2017 to July 2022.The distribution of teicoplanin cmin in elderly patients were collected.Various patient parameters were incorporated into both univariate and multivariate linear regression analyses to explore the related factors affecting the standard of teicoplanin cmin.The parameters included the patient's gender,age,height,body weight,initial loading dose of teicoplanin,serum albumin(ALB)levels,urea levels,creatinine clearance rate(Ccr),cystatin C levels,alanine aminotransferase(ALT)levels,aspartate aminotransferase(AST)levels,gamma-glutamyl transferase(GGT)levels,alkaline phosphatase(ALP)levels,total bilirubin(TBIL)levels,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score.RESULTS A total of 129 samples of teicoplanin cmin in 83 elderly patients were enrolled,and it was found that 88 samples(68.22%)reached the target concentration(10-30 mg·L-1),26 samples(20.16%)<10 mg·L-1 and 15 samples(11.63%)>30 mg·L-1.Multiple linear regression analysis revealed that gender(B=-3.130,95%CI=-6.219--0.042,P<0.05),the initial loading dosage of teicoplanin(B=31.251,95%CI=23.868-38.634,P<0.01),Ccr(B=-0.064,95%CI=-0.105--0.023,P<0.01),and the level of TBIL(B=-0.045,95%CI=-0.08--0.009,P<0.05)were correlated with the teicoplanin cmin in elderly patients.CONCLUSION The individual difference of teicoplanin cmin in elderly patients is large,and the influence of initial loading dose,Ccr and total bilirubin level should be considered when optimizing the dosage regimen of teicoplanin.