Analysis of factors associated with markedly elevated trough serum concentrations of teicoplanin after maintenance doses in critically ill patients
OBJECTIVE To explore the factors associated with an elevation of trough serum concentration of teicoplanin in critically ill patients after maintenance dose and provide references for its therapeutic monitoring.METHODS From February 2021 to February 2023,basic profiles,biochemical parameters and serum concentrations of teicoplanin were retrospectively reviewed for 41 patients hospitalized in intensive care unit of Nanjing Drum Tower Hospital.Trough serum teicoplanin concentra-tions were collected before and after maintenance doses.The changes of trough serum concentration of teicoplanin after mainte-nance dose were recorded.They were assigned into two groups of marked elevation(n=18,≥10.2 mg·L-1)and non-marked elevation(n=23,＜10.2 mg·L-1).Univariate and Logistic regression analyses were performed.RESULTS Among them,the second monitoring after maintenance dose spiked markedly[(27.5±11.0)vs.(17.3±6.70)mg·L-1,P＜0.01]than the first monitoring before maintenance dose with a mean rise of 10.2 mg·L-1.Univariate analysis revealed that maximal albumin,differ-ence between maximal albumin and minimal albumin and continuous renal replacement therapy between the first dose and the sec-ond concentration monitoring were risk factors for a marked elevation of teicoplanin(P＜0.05).Logistic regression revealed that difference between maximal albumin and minimal albumin was an independent risk factor.CONCLUSION Close monitoring of albumin changes is required after a maintenance dose of teicoplanin.Timely concentration monitoring of teicoplanin helps to improve its dosing safety.
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