PHARMACOKINETICS OF A SINGLE-DOSE OF TEICOPLANIN IN BURN PATIENTS

Patients with severe burns are susceptible to infection with Gram-posi tive organisms including methicillin-resistant Staphylococcus aureus, and often require higher antibiotic dosages compared with other patien ts. This study examined the pharmacokinetics of a single iv dose of te icoplanin (12 mg/kg) in 15 adults and five children with severe burns. Adults were aged 21-82 years with a median total body surface area (T BSA) burn of 30% (range 15-60%). Children were aged 10 months-10 years with median TBSA burn of 15% (10-30%). At 12 h, the median serum teic oplanin concentration was 12.8 mg/L (9.0-27.1 mg/L) in adults and 7.6 mg/L (6.6-10.8 mg/L) in children, (P < 0.01); at 24 h, the correspondi ng values were 8.3 mg/L (4.6-12.9 mg/L) and 5.2 mg/L (4.2-6.0 mg/L). U sing a three-compartment model, the median terminal half life in adult s was 114 h (47-278 h). Children fitted a two-compartment model with a terminal half-life of 38 h (21-41 h). The median concentration of tei coplanin in fluid from the burn wound was 60% of the serum antibiotic concentration. A single iv dose of 12 mg/kg of teicoplanin was suffici ent to produce therapeutic serum concentrations in burn patients for 2 4 h, but monitoring of antibiotic levels in serum may be advisable in those with high total clearance, especially children.