Bacterial infection with coagulase-negative staphylococci (CNS) or methicillin resistant and sensitive staphylococcus aureus(MRSA/MSSA) indicates poor prognosis and increased mortality in critically ill patients.
With the current emergence of glycopeptide-intermediate sensitive Staphylococcus aureus strains, personalized dosing of teicoplanin is of utmost importance to preserve the current therapeutic armamentarium.
Teicoplanin is considered equipotent to vancomycin, albeit safer with minimal nephrotoxicity. It is estimated that 50% of all critically ill patients treated with teicoplanin does not reach target exposure. This is the major driver for treatment failure and development of resistance and dose individualization will overcome this problem.
Our project is aimed at developing and implementing a personalized dosing strategy for teicoplanin, to prevent development of glycopeptide resistance and allow safe treatment of glycopeptide intermediate sensitive bacteria.
We aim to improve antibiotic treatment with teicplanin by:
1. Determining the total and unbound pharmacokinetic targets for teicoplanin using the hollow fiber model and pharmacokinetic-pharmacodynamic (PKPD) data analysis.
2. Characterize teicoplanin PK in critically ill patients with a specific focus on alterations of exposure due to variability in renal function.
3. Investigate the superiority of TDM-optimized dosing versus standard of care in critically ill patients.
4. Disseminating our findings to relevant societies and implement them in routine patient healthcare.