Teicoplanin

Class: Glycopeptide Antibiotic

Mechanism of Action: Inhibits bacterial cell wall synthesis by binding to D-alanyl-D-alanine terminus of cell wall precursors, preventing peptidoglycan polymerization. Primarily active against Gram-positive bacteria.

Indications

• Serious Gram-positive infections (including MRSA)
• Endocarditis
• Bone and joint infections
• Severe skin and soft tissue infections
• Sepsis due to susceptible Gram-positive organisms
• Prophylaxis in high-risk surgical procedures

Dosage

• Adults: 6–12 mg/kg IV once daily (loading dose: 6–12 mg/kg every 12 hours for 3–5 doses)
• Children: 10 mg/kg IV once daily (loading: 10 mg/kg every 12 hours for 3 doses)

Maximum Dose

Depends on patient weight and renal function; usually up to 12 mg/kg/day

Major Side Effects

• Nephrotoxicity (less common than vancomycin)
• Red man syndrome (rare)
• Rash, fever, eosinophilia
• Thrombocytopenia or neutropenia (rare)
• Local reaction at injection site

Contraindications

• Hypersensitivity to teicoplanin or other glycopeptides
• Use with caution in patients with renal impairment

Compatible Fluids

• 0.9% Sodium Chloride
• 5% Dextrose

Route of Administration

• Intravenous (IV) infusion
• Intramuscular (IM) injection

Type of Administration

• IV: infusion over 30–60 minutes
• IM: deep injection into a large muscle (rarely used)

Special Precautions

• Adjust dose in renal impairment
• Monitor renal function and blood counts during prolonged therapy
• Use caution in elderly patients and those with multiple comorbidities
• Prolonged use may cause superinfection