Clinical beta
FMBM is currently in clinical beta. Content is for professional review/testing and must not replace local protocols, senior clinical judgment, or official prescribing references.
Drug Monograph
Teicoplanin
Glycopeptide (IV, IM)
Indication
MRSA bacteremia/SSTI β’ enterococcal infection (susceptible) β’ orthopedic infection selected
INDICATIONS (CORE USE)
Like vancomycin for many GP infections β **long half-life** q24h after load; **not for C. diff first-line** (use vanco/fidaxo/metro).
ADULT DOSE (STANDARD)
Loading 6β12 mg/kg q12h Γ 3 doses then 6 mg/kg q24h β **product/regional variation**
MAX DOSE
Follow monograph β renal adjustment loading vs maintenance
Route
IV, IM
PEDIATRIC DOSE
Weight-based loading/maintenance per pediatric reference
Must-not-miss safety points
Major warning
- Ξ²-lactamβlike hypersensitivity rare but reported - Nephrotoxicity lower than vancomycin historically β still monitor - Red man possible β slow infusion - Not oral CDI standard therapy
USE IF: MRSA / susceptible enterococcal infection when teicoplanin on formulary and local experience supports. AVOID IF: First-line CDI therapy; need oral GP therapy (use other agents).
Primary
Secondary
Other
STANDARD (ADULT PO)
Load 6β12 mg/kg q12h Γ ~3 doses β 6 mg/kg q24h (product-specific)
ADULT DOSE
Loading regimen critical β do not start maintenance without loads per label
PEDIATRIC DOSE
Pediatric loading distinct β consult.
MAX DOSE
Renal failure β prolong interval after load
Practical Note
Trough monitoring used in some centers β follow local.
Clinical warnings
Adverse effects
Pediatrics
Weight-based loading/maintenance per pediatric reference
Pregnancy
Limited human data β use if needed
Lactation
caution.
Renal impairment
Reduce maintenance dose/interval in CKD after loading. **CrCl scaffold (FMBM β titrate to FDA/SFDA label + institutional pharmacy nomogram):** - **CrCl β₯50** β loading then maintenance per label - **CrCl 10β50** β prolong maintenance interval after load - **CrCl <10** / **HD** β extend interval; verify loading completed β **subtherapeutic risk** if load skipped
Hepatic impairment
No routine change.
Elderly
Renal dosing.
IV slow infusion; IM alternative OPAT.
Clinical Picture
**Life-threatening (first):** **anaphylaxis**; **AKI**; (rare) **arrhythmia** with electrolyte shifts. **Secondary:** red-man infusion reaction (rate-related).
Immediate Actions
Stop/slow infusion β treat hypersensitivity per severity; fluids; BMP; anaphylaxis β epinephrine if indicated
Antidote
No specific antidote; treat complications (e.g. anaphylaxis β epinephrine per ACLS)
Decontamination
N/A standard IV
Escalation
Anaphylaxis, severe AKI, life-threatening arrhythmia β **ICU**; **severe toxicity with renal failure β hemodialysis clears vancomycin** (and related glycopeptides per agent) β redose per level post-HD; ototoxic symptoms β ENT
Common mistakes, resistance logic, and bedside traps
Vancomycin alternative where stocked β **load then q24h**. Still GP-only systemic. Renal maintenance adjustment.
Compare local MIC data vs vancomycin. Stewardship: same MRSA rules β narrow duration. *Stewardship (all antimicrobials):* Empiric choice β syndrome severity + **local antibiogram**; shortest effective course.
Very long half-life allows q24h after loading; renal elimination.
Glycopeptide cell wall inhibition like vancomycin.
Saudi Arabia
Targocid, Teicoplanin
Global
(placeholder β verify local formulary)
Common trade names are curated examples only β formulations and availability vary. Verify the exact product name with your local pharmacy and national regulator before prescribing or dispensing.
Saudi Arabia
International