Pharmacokinetics of a single dose of teicoplanin in burn patients

Patients with severe bums are susceptible to infection with Gram-positive organisms including methicillin-resistant Staphylococcus aureus, and often require higher antibiotic dosages compared with other patients. This study examined the pharmacokinetics of a single iv dose of teicoplanin (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 (TBSA) 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 teicoplanin 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 corresponding values were 8.3 mg/L (4.6–12.9 mg/L) and 5.2 mg/L (4.2–6.0 mg/L). Using a three-compartment model, the median terminal half life in adults 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 teicoplanin in fluid from the burn wound was 60% of the serum antibiotic concentration. A single iv dose of 12 mg/kg of teicoplanin was sufficient to produce therapeutic serum concentrations in burn patients for 24 h, but monitoring of antibiotic levels in serum may be advisable in those with high total clearance, especially children.