Drug reference
The glycopeptide antibiotic teicoplanin has bactericidal activity against aerobic and anaerobic Gram- positive bacteria including multi-resistant staphylococci. However, there are reports of Staphylococcus aureus with reduced susceptibility to glycopeptides and increasing reports of glycopeptide-resistant enterococci. Teicoplanin is similar to vancomycin, but has a significantly longer duration of action, allowing once daily administration after the loading dose.
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Clostridioides difficile infection ▶BY MOUTH ▶Adult: 100–200 mg twice daily for 7–14 days Moderate diabetic foot infection | Severe diabetic foot infection | Leg ulcer infection ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Initially 6 mg/kg every 12 hours for 3 doses, then 6 mg/kg once daily Cellulitis | Erysipelas ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Initially 6 mg/kg every 12 hours for 3 doses, then 6 mg/kg once daily Serious infections caused by Gram-positive bacteria (e.g. complicated skin and soft-tissue infections, pneumonia, complicated urinary tract infections) ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION, OR BY INTRAMUSCULAR INJECTION ▶Adult: Initially 6 mg/kg every 12 hours for 3 doses, then 6 mg/kg once daily Streptococcal or enterococcal endocarditis (in Infection combination with another antibacterial) | Bone and joint infections ▶INITIALLY BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: 12 mg/kg every 12 hours for 3–5 doses, then (by intravenous injection or by intravenous infusion or by intramuscular injection) 12 mg/kg once daily Surgical prophylaxis ▶BY INTRAVENOUS INJECTION ▶Adult: 400 mg, to be administered up to 30 minutes before the procedure Surgical prophylaxis in open fractures ▶BY INTRAVENOUS INFUSION ▶Adult: 800 mg, to be administered up to 30 minutes before skeletal stabilisation and definitive soft-tissue closure Peritonitis associated with peritoneal dialysis (added to dialysis fluid) ▶BY INTRAPERITONEAL INFUSION ▶Adult: (consult local protocol)
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▶Teicoplanin should not be given by mouth for systemic infections because it is not absorbed significantly. l UNLICENSED USE Not licensed for surgical prophylaxis.
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Caution if history of vancomycin sensitivity.
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For choice of antibacterial therapy, see Antibacterials, use for prophylaxis p. 529, Cardiovascular system infections, antibacterial therapy p. 532, Diabetic foot infections, antibacterial therapy p. 533, Gastro-intestinal system infections, antibacterial therapy p. 535, Musculoskeletal system infections, antibacterial therapy p. 536, Respiratory system infections, antibacterial therapy p. 538, Skin infections, antibacterial therapy p. 540, Urinary-tract infections p. 622.
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→Appendix 1: teicoplanin
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▶Common or very common Fever. pain. skin reactions ▶Uncommon Bronchospasm. diarrhoea. dizziness. eosinophilia. headache. hearing impairment. hypersensitivity. leucopenia. nausea. ototoxicity. thrombocytopenia. vomiting ▶Rare or very rare Abscess. red man syndrome ▶Frequency not known Agranulocytosis. angioedema. chills . neutropenia. overgrowth of nonsusceptible organisms. renal impairment. seizure. severe cutaneous adverse reactions (SCARs). thrombophlebitis SIDE-EFFECTS, FURTHER INFORMATION Teicoplanin is associated with a lower incidence of nephrotoxicity than vancomycin.
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Manufacturer advises use only if potential benefit outweighs risk.
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No information available.
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Dose adjustments Use normal dose regimen on days 1–4, then use normal maintenance dose every 48 hours if eGFR 30–80 mL/minute/1.73 m2 and use normal maintenance dose every 72 hours if eGFR less than 30 mL/minute/1.73 m2. Monitoring Monitor renal and auditory function during prolonged treatment in renal impairment.
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▶With intramuscular use or intravenous use Manufacturer advises monitor serum-teicoplanin trough concentration at steady state after completion of loading dose and during maintenance treatment—consult product literature. ▶Blood counts and liver and kidney function tests required. ▶Manufacturer advises monitoring for adverse reactions when doses of 12 mg/kg twice daily are administered.
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▶With intravenous use For intravenous infusion (Targocid ®), give intermittently in Glucose 5% or Sodium chloride 0.9%; reconstitute initially with water for injections provided; infuse over 30 minutes. Continuous infusion not usually recommended. ▶With oral use Injection can be used to prepare solution for oral administration. Infection
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for injection Powder and solvent for solution for injection ELECTROLYTES: May contain Sodium A ▶Teicoplanin (non-proprietary) Teicoplanin 200 mg Teicoplanin 200mg powder and solvent for solution for injection vials | 1 vial P £4.45 DT = £3.93 Teicoplanin 400 mg Teicoplanin 400mg powder and solvent for solution for injection vials | 1 vial P £7.57 DT = £7.32 ▶Targocid (Sanofi) A Teicoplanin 200 mg Targocid 200mg powder and solvent for solution for injection vials | 1 vial P £3.93 DT = £3.93 Teicoplanin 400 mg Targocid 400mg powder and solvent for solution for injection vials | 1 vial P £7.32 DT = £7.32
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100–200 mg twice daily for 7–14 days
First-line fragment. Read the complete Indications and Dose section above.
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Initially 6 mg/kg every 12 hours for 3 doses, then
First-line fragment. Read the complete Indications and Dose section above.
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Initially 6 mg/kg every 12 hours for 3 doses, then
First-line fragment. Read the complete Indications and Dose section above.
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Initially 6 mg/kg every 12 hours for 3 doses, then
First-line fragment. Read the complete Indications and Dose section above.
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12 mg/kg every 12 hours for 3–5 doses, then (by
First-line fragment. Read the complete Indications and Dose section above.
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400 mg, to be administered up to 30 minutes
First-line fragment. Read the complete Indications and Dose section above.
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800 mg, to be administered up to 30 minutes
First-line fragment. Read the complete Indications and Dose section above.
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(consult local protocol)
First-line fragment. Read the complete Indications and Dose section above.
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