Makindo Medical Notes

🦠 Active against aerobic and anaerobic Gram-positive bacteria, including multi-resistant Staphylococcus aureus (MRSA), though resistance is increasingly reported.

📖 About

Always check the BNF link here.

• 📌 Glycopeptide antibiotic, alternative to vancomycin.
• 🧪 Levels must be monitored closely in high-risk groups.

⚙️ Action

• 🔗 Glycopeptide – bactericidal activity via inhibition of cell wall synthesis.

💉 Indications

• 🏥 Serious Gram-positive infections, including infective endocarditis.
• 🩺 Staphylococcus aureus infections (including MRSA).
• 💧 Dialysis-associated peritonitis.
• 💊 Alternative to vancomycin when intolerance or toxicity occurs.

📊 Dose (check BNF / datasheet)

• 💉 400 mg IM/IV every 12 hrs for 1–3 doses, then 200 mg OD (maintenance).
• 🎯 Target trough: 10–60 mg/L (15–60 mg/L in endocarditis).
• 🧠 Severe infections / endocarditis: 10 mg/kg 12-hrly for 3–5 doses, then 10 mg/kg OD.
• 🦴 Bone/joint infections: 12 mg/kg 12-hrly for 3–5 doses, then 12 mg/kg OD.
• 🔥 MRSA, severe burns:   • <70 kg → 400 mg 12-hrly for 3 doses, then 400 mg OD.   • >70 kg → 6 mg/kg 12-hrly for 3 doses, then 6 mg/kg OD.
• 💩 C. difficile infection: 100–200 mg PO every 12 hrs for 10–14 days.

🔄 Interactions

• 👂 Ototoxicity risk ↑ with aminoglycosides or loop diuretics.
• 💧 Nephrotoxicity risk ↑ with other nephrotoxic drugs (e.g. ciclosporin, amphotericin B).

⚠️ Cautions

• 💧 Renal impairment (dose adjustment needed).
• 👵 Elderly patients more susceptible to nephro/ototoxicity.
• 🧪 Monitor teicoplanin levels and renal function in: severe burns, sepsis, deep staphylococcal infection, endocarditis, renal failure, elderly.

⛔ Contraindications

• 🚫 Hypersensitivity to teicoplanin or vancomycin (cross-reactivity possible).
• ⚠️ Avoid or closely monitor with concurrent nephrotoxic/ototoxic agents.

💥 Side Effects

• 🤢 GI: nausea, vomiting, diarrhoea.
• 🩸 Haematological: eosinophilia, leucopenia, neutropenia, thrombocytopenia.
• 👂 Ototoxicity: vestibular disorders, tinnitus, hearing loss.
• 💧 Nephrotoxicity (rare but serious).

📚 References

• Teicoplanin in BNF