Teicoplanin is administered parenterally (intravenously or intramuscularly). Intravenous (IV) administration can be performed by either intravenous injection for 3-5 minutes, or - IV infusion for 30 minutes. In newborns, the drug should be administered only as an intravenous infusion.
Dosing regimen in adults and adolescents 16-18 years with normal renal function
Treatment of infections caused by drug-sensitive gram-positive bacteria (endocarditis, septicemia, bone and joint infections, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections) For moderately severe infections of the skin and soft tissues, urinary tracts, lower respiratory tract infections, the initial dose of teicoplanin is 400 mg once iv on the first day, followed by a maintenance dose of 200 mg once daily in / in or intramuscularly (IM).
For treatment of severe infections of bones and joints, septicemia, endocarditis, the initial dose is 400 mg IV every 12 hours for the first three doses followed by a maintenance dose of 400 mg IV or IM once daily. In severe infections, the minimum concentration in serum should not be less than 10 mg / L. Maximum concentrations, determined 1 hour after iv injection of 400 mg, are usually in the range of 20 to 50 mg / l.
In some cases (in burn patients or in patients with endocarditis), the maintenance dose may be up to 12 mg / kg of body weight per day. Standard doses of 200 mg and 400 mg correspond to doses of 3 mg / kg and 6 mg / kg of body weight. In patients with a body weight of more than 85 kg, it is recommended to adjust the dose of the drug taking into account the body weight, adhering to the same therapeutic regimen: moderately severe infections of 3 mg / kg, severe infections of 6 mg / kg.
Patients with peritonitis developed as a complication of continuous ambulatory peritoneal dialysis
After a single loading dose of 400 mg intravenously, in the first week, 20 mg / l is injected into each tank with peritoneal dialysis solution, in the second week, 20 mg / l is administered per each second peritoneal dialysis solution reservoir in The third week is administered at a dose of 20 mg / l to a tank with peritoneal dialysis solution for night dialysis.
Antimicrobial prophylaxis in surgical operations in orthopedics, dental operations (for example, endocarditis prophylaxis in patients with artificial heart valves): 400 mg teicoplanin (or 6 mg / kg with a patient weight of more than 85 kg) as an IV injection once during anesthesia. Pseudomembranous colitis caused by C. difficile: 200 mg of teicoplanin orally two times a day.
Dosage regimen in children
Children over 2 months to 16 years of age: for most Gram-positive infections, the recommended initial dose is 10 mg / kg body weight IV with an interval of 12 hours for the first three doses, with the transition to a maintenance dose of 6 mg / kg body weight given in / m or / once a day.
In severe infections and neutropenia, the recommended initial dose is 10 mg / kg body weight IV with an interval of 12 hours for the first three doses with the transition to a maintenance dose of 10 mg / kg body weight administered / once a day.
Children younger than 2 months, including newborns: the recommended initial dose is 16 mg / kg body weight IV on the first day with the transition to a maintenance dose of 8 mg / kg body weight IV once a day. IV administration should be carried out by iv infusion for 30 minutes.
Dosage regimen in elderly patients
With normal kidney function, dosage adjustment is not required.
Dosing regimen in adults with renal insufficiency
Until the 4th day of treatment with teicoplanin, correction of the dosing regimen is not required. Beginning on the fourth day, the administered dose should maintain the teicoplanin concentration in the serum at a level of 10 mg / L.
With moderate renal failure (creatinine clearance 40-60 ml / min): the maintenance dose should be reduced by half, either by introducing the previous dose once every two days, or by administering a half dose once a day.
In severe renal failure (creatinine clearance less than 40 ml / min) and in patients on hemodialysis: the maintenance dose should be reduced threefold,either by administering the previous dose every third day, or introducing 1/3 of the previous dose once a day.
Teikoplanin is not excreted by hemodialysis.
Duration of treatment
The response therapeutic response in most patients with infections caused by susceptible antibiotics is observed within 48-72 hours after the start of the drug administration. The total duration of treatment is determined individually and depends on the type and severity of the infection and the clinical response of the individual patient. With endocarditis and osteomyelitis, treatment is recommended for 3 weeks or more; while Targotsid® should not be administered for more than 4 months. Preparation of the solution
All contents of the ampoule with sterile water should be slowly introduced into the tare of the Targotsid® preparation, gently shaking the bottle until the powder completely dissolves, while avoiding the formation of foam. It is very important that the whole preparation is dissolved, even the part that is near the cork.
When the solution is shaken, a foam is formed, which makes it difficult to extract the required volume of the solution. However, if teicoplanin the foam does not change the concentration of the remaining solution of 200 mg / 3 ml in the bottle of the drug Targosid® 200 mg and 400 mg / 3 ml in the Targocid® 400 mg bottle. If the solution turns frothy, then leave it to stand for about 15 minutes to reduce the amount of foam.
It is necessary to slowly extract the teicoplanin solution from the vial, trying to extract it completely, piercing the middle of the rubber cork with a needle.
The resulting solution will contain 200 mg of teicoplanin in 3 ml in a 200 mg Targogid® and 400 mg in 3 ml bottle of Targogid® 400 mg.
It is important that the preparation of the solution is carried out correctly, and the solution is carefully removed from the vial; improper preparation of the solution can lead to a lower dose than required.
The prepared solution is isotonic and has a pH of 7.2-7.8.
The prepared solution can be directly injected or further diluted with 0.9% sodium chloride solution, Ringer's solution, Hartman's solution, 5 % dextrose solution, peritoneal dialysis solution containing 1.36 % or 3.86 % dextrose.