Teicoplanin

Adults: Teicoplanin can be given into a vein, either as a bolus injection or as an infusion, or into a muscle. The intravenous injection may be given either as a bolus over 3 to 5 minutes or as a 30 minute infusion. Only the infusion method should be used in newborns. It should be given once daily after one or more loading doses. The dose of Teicoplanin should be adapted according to the severity of the infection and the patient's response to treatment. In adults with normal kidney function, a dose of 6 mg/kg (generally 400 mg) intravenously is recommended on the first day. On the following days, the dose may be 6 mg/kg/day (generally 400 mg) intravenously or 3 mg/kg/day (generally 200 mg) intravenously or intramuscularly as a single daily dose. The highest dose and the intravenous route are recommended for serious infections. In potentially fatal infections, treatment should be started with 6 mg/kg (usually 400 mg) twice daily for 1 to 4 days as a loading dose and continued with 6 mg/kg/day intravenously on the following days as a maintenance dose. In adults and elderly patients with kidney failure, the dose should be adjusted from the 4th day of treatment as follows. In moderate kidney failure, with a creatinine clearance between 40 and 60 ml per minute, the daily dose of Teicoplanin should be halved or given on alternate days. In severe kidney failure, with a creatinine clearance less than 40 ml per minute, and in patients on hemodialysis, the daily dose of Teicoplanin should be reduced to a third, or given every 3 days. If creatinine clearance is equal to or less than 20 ml per minute, treatment with Teicoplanin may be given only if monitoring of drug levels in the blood can be guaranteed. In children with normal kidney function, aged 2 months to 12 years, treatment should be started at a dose of 10 mg/kg every 12 hours for a total of 3 doses and then continued at a dose of 6 to 10 mg/kg/day, with the highest dose used for the most serious infections or for children with neutropenia. In neonates up to 2 months old, treatment should be started at a dose of 16 mg/kg on the first day, followed by maintenance doses of 8 mg/kg/day by slow intravenous infusion lasting approximately 30 minutes. In children with kidney failure, dosage adjustment is recommended just as in adults, and measuring Teicoplanin levels in the blood may be useful to make treatment as effective as possible. For Clostridium difficile associated diarrhea, the recommended dose is 100 to 200 mg given twice a day for 7 to 14 days. Giving Teicoplanin along with another suitable bactericidal antibiotic is recommended for infections requiring maximum bactericidal activity, or in situations where the presence of Gram negative bacteria cannot be ruled out, such as empirical treatment of fever in patients with neutropenia. In most patients, this medicine can be seen to have an effect 48 to 72 hours after the start of treatment. However, the total duration of treatment is determined based on the type and severity of the infection and the patient's response to treatment. In endocarditis and osteomyelitis, a period of at least 3 weeks is recommended.