Warning

Audience

  • Argyll & Bute HSCP and/or Highland HSCP
  • Primary and/or Secondary Care.

Prescribing

Teicoplanin is a protected antimicrobial and as such should only be initiated following consultation with an infection specialist.

Note teicoplanin doses are based on actual bodyweight (ABW) and dosing frequency after loading is based on renal function.

Calculate renal function using on-line calculator

  • (use gentamicin/vancomycin/BNF) or Cockcroft Gault equation (using ideal body weight if actual weight >20% over ideal).
  • DO NOT use eGFR to determine drug dosing in renal impairment.
CrCl (mL/min)

 

=

[140 - age (years)] x weight (kg)

Serum creatinine (micromol/L

Multiply figure obtained above by 1·23 for males and 1·04 for females.  

For glossary of terms see Glossary.

Bone and joint infection, severe skin and soft tissue infection OR complication line infections WITH sepsis or bacteraemia or significant cellulitis 

STEP ONE: Loading

IV 12mg/kg (ABW) to max 800mg
Every 12 hours for 4 doses

STEP TWO: Maintenance Dose

Start maintenance dose 24, 48 or 72 hours after the last loading dose depending on renal function:

Creatinine clearance (CrCI) 

Teicoplanin dose (ABW to max 1000mg) 

Above 80mL/min

IV 12mg/kg daily 

30 to 80mL/min 

IV 12mg/kg every 48 hours 

Less than 30mL/min

IV 12mg/kg every 72 hours 

  • Do not use eGFR, creatinine clearance must be calculated using "Cockcroft Gault" 
  • Round dose to nearest 100mg 
  • Administer as IV infusion over 60mins 

STEP THREE: Teicoplanin Levels

Pre-dose Trough 20 to 30mg/L

Monitoring

  • If expected duration of therapy is longer than 10 days, take 1st teicoplanin trough sample at least 72 hours after loading doses are complete, then once weekly thereafter, according to Microbiology advice.
  • Teicoplanin samples are sent to a Bristol laboratory for analysis and can take up to 3 to 5 days to be reported.
  • Continue with the same regimen until result available.
  • Seek advice from pharmacy if trough level out of recommended range or if significant deterioration OR improvement in renal function.
  • For choice of tube, see Quick Reference Guide for Blood Science (NHS Highland intranet access required).

Note: OPAT Service uses a separate protocol for three times a week dosing – see NHS Tayside 3 x Weekly Teicoplanin guidance.

Adapted with permission from NHS Greater Glasgow and Clyde policy version 5 approved February 2022
NHS Tayside guidance used with permission August 2022

Last reviewed: 27/10/2022

Next review date: 31/10/2025

Author(s): Antimicrobial Management Team.

Version: 2

Approved By: TAMSG of the ADTC

Reviewer name(s): Alison MacDonald, Area Antimicrobial Pharmacist.

Document Id: AMT178

Internal URL: https://nhshighlands.azurewebsites.net/umbraco/#/content/content/edit/14540

Related resources

Further information for Patients

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Self-management information

References

Further information for Health Care Professionals

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