Variability in protein binding of teicoplanin and achievement of therapeutic drug monitoring targets in critically ill patients: lessons from the DALI Study.
Identifieur interne : 001863 ( Ncbi/Merge ); précédent : 001862; suivant : 001864Variability in protein binding of teicoplanin and achievement of therapeutic drug monitoring targets in critically ill patients: lessons from the DALI Study.
Auteurs : J A Roberts [Australie] ; V. Stove [Belgique] ; J J De Waele [Belgique] ; B. Sipinkoski [Australie] ; B. Mcwhinney [Australie] ; J P J. Ungerer [Australie] ; M. Akova [Turquie] ; M. Bassetti [Italie] ; G. Dimopoulos [Grèce] ; K-M Kaukonen [Australie] ; D. Koulenti [Grèce] ; C. Martin [France] ; P. Montravers [France] ; J. Rello [Espagne] ; A. Rhodes [Royaume-Uni] ; T. Starr [Australie] ; S C Wallis [Australie] ; J. Lipman [Australie]Source :
- International journal of antimicrobial agents [ 1872-7913 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Antibactériens (administration et posologie), Antibactériens (métabolisme), Antibactériens (pharmacocinétique), Chromatographie, Coopération internationale, Femelle, Humains, Jeune adulte, Liaison aux protéines, Maladie grave, Mâle, Plasma sanguin (), Sujet âgé, Surveillance pharmacologique, Téicoplanine (administration et posologie), Téicoplanine (métabolisme), Téicoplanine (pharmacocinétique).
- MESH :
- administration et posologie : Antibactériens, Téicoplanine.
- métabolisme : Antibactériens, Téicoplanine.
- pharmacocinétique : Antibactériens, Téicoplanine.
- Adulte, Adulte d'âge moyen, Chromatographie, Coopération internationale, Femelle, Humains, Jeune adulte, Liaison aux protéines, Maladie grave, Mâle, Plasma sanguin, Sujet âgé, Surveillance pharmacologique.
English descriptors
- KwdEn :
- Adult, Aged, Anti-Bacterial Agents (administration & dosage), Anti-Bacterial Agents (metabolism), Anti-Bacterial Agents (pharmacokinetics), Chromatography, Critical Illness, Drug Monitoring, Female, Humans, International Cooperation, Male, Middle Aged, Plasma (chemistry), Protein Binding, Teicoplanin (administration & dosage), Teicoplanin (metabolism), Teicoplanin (pharmacokinetics), Young Adult.
- MESH :
- chemical , administration & dosage : Anti-Bacterial Agents, Teicoplanin.
- chemical , metabolism : Anti-Bacterial Agents, Teicoplanin.
- chemical , pharmacokinetics : Anti-Bacterial Agents, Teicoplanin.
- chemistry : Plasma.
- Adult, Aged, Chromatography, Critical Illness, Drug Monitoring, Female, Humans, International Cooperation, Male, Middle Aged, Protein Binding, Young Adult.
Abstract
The aims of this study were to describe the variability in protein binding of teicoplanin in critically ill patients as well as the number of patients achieving therapeutic target concentrations. This report is part of the multinational pharmacokinetic DALI Study. Patients were sampled on a single day, with blood samples taken both at the midpoint and the end of the dosing interval. Total and unbound teicoplanin concentrations were assayed using validated chromatographic methods. The lower therapeutic range of teicoplanin was defined as total trough concentrations from 10 to 20 mg/L and the higher range as 10-30 mg/L. Thirteen critically ill patients were available for analysis. The following are the median (interquartile range) total and free concentrations (mg/L): midpoint, total 13.6 (11.2-26.0) and free 1.5 (0.7-2.5); trough, total 11.9 (10.2-22.7) and free 1.8 (0.6-2.6). The percentage free teicoplanin for the mid-dose and trough time points was 6.9% (4.5-15.6%) and 8.2% (5.5-16.4%), respectively. The correlation between total and free antibiotic concentrations was moderate for both the midpoint (ρ = 0.79, P = 0.0021) and trough (ρ = 0.63, P = 0.027). Only 42% and 58% of patients were in the lower and higher therapeutic ranges, respectively. In conclusion, use of standard dosing for teicoplanin leads to inappropriate concentrations in a high proportion of critically ill patients. Variability in teicoplanin protein binding is very high, placing significant doubt on the validity of total concentrations for therapeutic drug monitoring in critically ill patients.
DOI: 10.1016/j.ijantimicag.2014.01.023
PubMed: 24630304
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pubmed:24630304Le document en format XML
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<author><name sortKey="Stove, V" sort="Stove, V" uniqKey="Stove V" first="V" last="Stove">V. Stove</name>
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<author><name sortKey="De Waele, J J" sort="De Waele, J J" uniqKey="De Waele J" first="J J" last="De Waele">J J De Waele</name>
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<author><name sortKey="Sipinkoski, B" sort="Sipinkoski, B" uniqKey="Sipinkoski B" first="B" last="Sipinkoski">B. Sipinkoski</name>
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<author><name sortKey="Akova, M" sort="Akova, M" uniqKey="Akova M" first="M" last="Akova">M. Akova</name>
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<author><name sortKey="Bassetti, M" sort="Bassetti, M" uniqKey="Bassetti M" first="M" last="Bassetti">M. Bassetti</name>
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<author><name sortKey="Dimopoulos, G" sort="Dimopoulos, G" uniqKey="Dimopoulos G" first="G" last="Dimopoulos">G. Dimopoulos</name>
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<author><name sortKey="Koulenti, D" sort="Koulenti, D" uniqKey="Koulenti D" first="D" last="Koulenti">D. Koulenti</name>
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<wicri:regionArea>Centre Hospitalier Universitaire Bichat-Claude Bernard, AP-HP, Université Paris VII, Paris</wicri:regionArea>
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<author><name sortKey="Rello, J" sort="Rello, J" uniqKey="Rello J" first="J" last="Rello">J. Rello</name>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>CIBERES, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
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<author><name sortKey="Rhodes, A" sort="Rhodes, A" uniqKey="Rhodes A" first="A" last="Rhodes">A. Rhodes</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>St George's Healthcare NHS Trust and St George's University of London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
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<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
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<author><name sortKey="Starr, T" sort="Starr, T" uniqKey="Starr T" first="T" last="Starr">T. Starr</name>
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<author><name sortKey="Wallis, S C" sort="Wallis, S C" uniqKey="Wallis S" first="S C" last="Wallis">S C Wallis</name>
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<author><name sortKey="Lipman, J" sort="Lipman, J" uniqKey="Lipman J" first="J" last="Lipman">J. Lipman</name>
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<series><title level="j">International journal of antimicrobial agents</title>
<idno type="eISSN">1872-7913</idno>
<imprint><date when="2014" type="published">2014</date>
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<term>Aged</term>
<term>Anti-Bacterial Agents (administration & dosage)</term>
<term>Anti-Bacterial Agents (metabolism)</term>
<term>Anti-Bacterial Agents (pharmacokinetics)</term>
<term>Chromatography</term>
<term>Critical Illness</term>
<term>Drug Monitoring</term>
<term>Female</term>
<term>Humans</term>
<term>International Cooperation</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Plasma (chemistry)</term>
<term>Protein Binding</term>
<term>Teicoplanin (administration & dosage)</term>
<term>Teicoplanin (metabolism)</term>
<term>Teicoplanin (pharmacokinetics)</term>
<term>Young Adult</term>
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<term>Adulte d'âge moyen</term>
<term>Antibactériens (administration et posologie)</term>
<term>Antibactériens (métabolisme)</term>
<term>Antibactériens (pharmacocinétique)</term>
<term>Chromatographie</term>
<term>Coopération internationale</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Liaison aux protéines</term>
<term>Maladie grave</term>
<term>Mâle</term>
<term>Plasma sanguin ()</term>
<term>Sujet âgé</term>
<term>Surveillance pharmacologique</term>
<term>Téicoplanine (administration et posologie)</term>
<term>Téicoplanine (métabolisme)</term>
<term>Téicoplanine (pharmacocinétique)</term>
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<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-Bacterial Agents</term>
<term>Teicoplanin</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Anti-Bacterial Agents</term>
<term>Teicoplanin</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Anti-Bacterial Agents</term>
<term>Teicoplanin</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antibactériens</term>
<term>Téicoplanine</term>
</keywords>
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<keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Antibactériens</term>
<term>Téicoplanine</term>
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<keywords scheme="MESH" qualifier="pharmacocinétique" xml:lang="fr"><term>Antibactériens</term>
<term>Téicoplanine</term>
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<term>Aged</term>
<term>Chromatography</term>
<term>Critical Illness</term>
<term>Drug Monitoring</term>
<term>Female</term>
<term>Humans</term>
<term>International Cooperation</term>
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<term>Chromatographie</term>
<term>Coopération internationale</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Liaison aux protéines</term>
<term>Maladie grave</term>
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<front><div type="abstract" xml:lang="en">The aims of this study were to describe the variability in protein binding of teicoplanin in critically ill patients as well as the number of patients achieving therapeutic target concentrations. This report is part of the multinational pharmacokinetic DALI Study. Patients were sampled on a single day, with blood samples taken both at the midpoint and the end of the dosing interval. Total and unbound teicoplanin concentrations were assayed using validated chromatographic methods. The lower therapeutic range of teicoplanin was defined as total trough concentrations from 10 to 20 mg/L and the higher range as 10-30 mg/L. Thirteen critically ill patients were available for analysis. The following are the median (interquartile range) total and free concentrations (mg/L): midpoint, total 13.6 (11.2-26.0) and free 1.5 (0.7-2.5); trough, total 11.9 (10.2-22.7) and free 1.8 (0.6-2.6). The percentage free teicoplanin for the mid-dose and trough time points was 6.9% (4.5-15.6%) and 8.2% (5.5-16.4%), respectively. The correlation between total and free antibiotic concentrations was moderate for both the midpoint (ρ = 0.79, P = 0.0021) and trough (ρ = 0.63, P = 0.027). Only 42% and 58% of patients were in the lower and higher therapeutic ranges, respectively. In conclusion, use of standard dosing for teicoplanin leads to inappropriate concentrations in a high proportion of critically ill patients. Variability in teicoplanin protein binding is very high, placing significant doubt on the validity of total concentrations for therapeutic drug monitoring in critically ill patients.</div>
</front>
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<DateCreated><Year>2014</Year>
<Month>04</Month>
<Day>28</Day>
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<DateCompleted><Year>2014</Year>
<Month>12</Month>
<Day>09</Day>
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<DateRevised><Year>2014</Year>
<Month>04</Month>
<Day>28</Day>
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<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7913</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>43</Volume>
<Issue>5</Issue>
<PubDate><Year>2014</Year>
<Month>May</Month>
</PubDate>
</JournalIssue>
<Title>International journal of antimicrobial agents</Title>
<ISOAbbreviation>Int. J. Antimicrob. Agents</ISOAbbreviation>
</Journal>
<ArticleTitle>Variability in protein binding of teicoplanin and achievement of therapeutic drug monitoring targets in critically ill patients: lessons from the DALI Study.</ArticleTitle>
<Pagination><MedlinePgn>423-30</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijantimicag.2014.01.023</ELocationID>
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<Abstract><AbstractText>The aims of this study were to describe the variability in protein binding of teicoplanin in critically ill patients as well as the number of patients achieving therapeutic target concentrations. This report is part of the multinational pharmacokinetic DALI Study. Patients were sampled on a single day, with blood samples taken both at the midpoint and the end of the dosing interval. Total and unbound teicoplanin concentrations were assayed using validated chromatographic methods. The lower therapeutic range of teicoplanin was defined as total trough concentrations from 10 to 20 mg/L and the higher range as 10-30 mg/L. Thirteen critically ill patients were available for analysis. The following are the median (interquartile range) total and free concentrations (mg/L): midpoint, total 13.6 (11.2-26.0) and free 1.5 (0.7-2.5); trough, total 11.9 (10.2-22.7) and free 1.8 (0.6-2.6). The percentage free teicoplanin for the mid-dose and trough time points was 6.9% (4.5-15.6%) and 8.2% (5.5-16.4%), respectively. The correlation between total and free antibiotic concentrations was moderate for both the midpoint (ρ = 0.79, P = 0.0021) and trough (ρ = 0.63, P = 0.027). Only 42% and 58% of patients were in the lower and higher therapeutic ranges, respectively. In conclusion, use of standard dosing for teicoplanin leads to inappropriate concentrations in a high proportion of critically ill patients. Variability in teicoplanin protein binding is very high, placing significant doubt on the validity of total concentrations for therapeutic drug monitoring in critically ill patients.</AbstractText>
<CopyrightInformation>Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Roberts</LastName>
<ForeName>J A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo><Affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. Electronic address: j.roberts2@uq.edu.au.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Stove</LastName>
<ForeName>V</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Ghent University Hospital, Ghent, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>De Waele</LastName>
<ForeName>J J</ForeName>
<Initials>JJ</Initials>
<AffiliationInfo><Affiliation>Ghent University Hospital, Ghent, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sipinkoski</LastName>
<ForeName>B</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Queensland Pathology, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
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<AffiliationInfo><Affiliation>Queensland Pathology, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
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<ForeName>J P J</ForeName>
<Initials>JP</Initials>
<AffiliationInfo><Affiliation>Queensland Pathology, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Akova</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Hacettepe University, School of Medicine, Ankara, Turkey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bassetti</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Azienda Ospedaliera-Universitaria 'Santa Maria della Misericordia', Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dimopoulos</LastName>
<ForeName>G</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>'Attikon' University Hospital, Athens, Greece.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kaukonen</LastName>
<ForeName>K-M</ForeName>
<Initials>KM</Initials>
<AffiliationInfo><Affiliation>Helsinki University Central Hospital, Helsinki, Finland; Australian and New Zealand Intensive Care Research Centre (ANZIC RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Koulenti</LastName>
<ForeName>D</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia; 'Attikon' University Hospital, Athens, Greece.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Martin</LastName>
<ForeName>C</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Hôpital Nord, Marseille, France; AzuRea Group, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Montravers</LastName>
<ForeName>P</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Centre Hospitalier Universitaire Bichat-Claude Bernard, AP-HP, Université Paris VII, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rello</LastName>
<ForeName>J</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>CIBERES, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rhodes</LastName>
<ForeName>A</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>St George's Healthcare NHS Trust and St George's University of London, London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Starr</LastName>
<ForeName>T</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wallis</LastName>
<ForeName>S C</ForeName>
<Initials>SC</Initials>
<AffiliationInfo><Affiliation>Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lipman</LastName>
<ForeName>J</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>DALI Study Authors</CollectiveName>
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<Language>eng</Language>
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<ArticleDate DateType="Electronic"><Year>2014</Year>
<Month>02</Month>
<Day>22</Day>
</ArticleDate>
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<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>Int J Antimicrob Agents</MedlineTA>
<NlmUniqueID>9111860</NlmUniqueID>
<ISSNLinking>0924-8579</ISSNLinking>
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<ForeName>Therese</ForeName>
<Initials>T</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Wallis</LastName>
<ForeName>Steven C</ForeName>
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<ForeName>Sanjoy</ForeName>
<Initials>S</Initials>
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<Investigator ValidYN="Y"><LastName>Ribas</LastName>
<ForeName>Antonio Margarit</ForeName>
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