Overview
Teicoplanin is a glycopeptide antibiotic used primarily for serious Gram-positive bacterial infections, including methicillin-resistant Staphylococcus aureus (MRSA). It inhibits bacterial cell wall synthesis and is administered intravenously or intramuscularly.
Mechanism of Action
Teicoplanin inhibits bacterial cell wall synthesis by binding to the D-alanyl-D-alanine terminus of cell wall precursor units, preventing cross-linking and leading to cell lysis and death. It is bactericidal against most susceptible organisms.
Indications
- Serious Gram-positive infections
- Methicillin-resistant Staphylococcus aureus (MRSA) infections
- Skin and soft tissue infections
- Bone and joint infections
- Endocarditis
- Peritonitis associated with peritoneal dialysis
- Prophylaxis in surgical procedures with high risk of Gram-positive infection
Dosage
Dosage varies by indication, patient weight, and renal function. Typical adult dose: 400 mg IV/IM loading dose on day 1, then 200-400 mg daily. Adjust for renal impairment. Pediatric dosing based on weight.
Contraindications
- Hypersensitivity to teicoplanin or other glycopeptide antibiotics
- Severe renal impairment without dose adjustment
Side Effects
- Injection site reactions
- Fever
- Rash
- Pruritus
- Nausea
- Diarrhea
- Elevated liver enzymes
- Renal impairment
- Ototoxicity
- Blood disorders (eosinophilia, thrombocytopenia)
Interactions
- Aminoglycosides: increased risk of nephrotoxicity and ototoxicity
- Loop diuretics: may enhance ototoxicity
- Other nephrotoxic drugs: additive renal toxicity