Teicoplanin

Summary

Teicoplanin is a glycopeptide antibiotic produced by Actinoplanes teichomyceticus, used to treat serious Gram-positive bacterial infections including MRSA, endocarditis, and Clostridioides difficile infections. It has a longer half-life than vancomycin, allowing once-daily dosing after loading.

Mechanism of Action

Inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors, preventing transglycosylation and transpeptidation, leading to bacterial cell death

Routes of Administration

Goals & Uses

• Treatment of skin and soft tissue infectionsAntimicrobial TherapyHigh
• Treatment of MRSA infectionsAntimicrobialHigh
• Treatment of Clostridioides difficile infectionAntimicrobialModerate
• Treatment of endocarditisAntimicrobial TherapyHigh
• Surgical prophylaxisInfection PreventionModerate

Contraindications

• Hypersensitivity to teicoplaninAllergyHigh
• Severe renal impairment (without dose adjustment)Organ ImpairmentModerate
• Known cross-reactivity with vancomycin in severe reactionsAllergyHigh

Adverse Effects

• Injection site reactionsLocalCommon
• ThrombocytopeniaHematologicUncommonLow platelet count
• OtotoxicityAuditory/vestibularRare
• Red man syndromeInfusion ReactionUncommon
• Elevated liver enzymesHepaticUncommonIncrease in AST/ALT or other hepatic markers
• NephrotoxicityRenalUncommon

Drug Interactions

• AminoglycosidesHigh
• CiclosporinModerate
• NSAIDsModerateMay increase renal risk in susceptible patients
• Loop diuretics (e.g., furosemide)Moderate

Population Constraints

• PregnancyReproductive SafetyRelative
• Neonates and infantsPediatricRelative
• Renal impairmentOrgan ImpairmentRelative
• Elderly patientsAgeRelative

Regulatory Status

• European UnionApprovedApproved: Serious Gram-positive infections including MRSA, Endocarditis, Skin and soft tissue infections, Bone and joint infections, Septicemia, Peritoneal dialysis-associated peritonitisApproved and widely used across EU member states; available as Targocid
• United StatesUnapprovedNot FDA-approved in the United States; vancomycin and daptomycin used as alternatives for similar indications
• United KingdomApprovedApproved: Serious Gram-positive infections, MRSA infections, Endocarditis, Skin and soft tissue infectionsApproved by MHRA; available as Targocid; included in UK hospital formularies

Approved in the EU and UK; not FDA-approved in the United States. Used as an alternative to vancomycin in many countries.

Evidence & Sources

No sources recorded yet.