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Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia

Background and Objectives: Teicoplanin (TEIC) is an effective drug for patients with febrile neutropenia (FN); however, it has been reported that these patients may have increased TEIC clearance compared with patients who do not have FN. The purpose of this study was to study therapeutic drug monito...

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Autores principales: Takigawa, Masaki, Tanaka, Hiroyuki, Suwa, Junichi, Obara, Tomoya, Maeda, Yohei, Sato, Mamoru, Shimazaki, Yoshitomo, Onoda, Toshihisa, Ishigami, Akihito, Ishii, Toshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145105/
https://www.ncbi.nlm.nih.gov/pubmed/37109716
http://dx.doi.org/10.3390/medicina59040758
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author Takigawa, Masaki
Tanaka, Hiroyuki
Suwa, Junichi
Obara, Tomoya
Maeda, Yohei
Sato, Mamoru
Shimazaki, Yoshitomo
Onoda, Toshihisa
Ishigami, Akihito
Ishii, Toshihiro
author_facet Takigawa, Masaki
Tanaka, Hiroyuki
Suwa, Junichi
Obara, Tomoya
Maeda, Yohei
Sato, Mamoru
Shimazaki, Yoshitomo
Onoda, Toshihisa
Ishigami, Akihito
Ishii, Toshihiro
author_sort Takigawa, Masaki
collection PubMed
description Background and Objectives: Teicoplanin (TEIC) is an effective drug for patients with febrile neutropenia (FN); however, it has been reported that these patients may have increased TEIC clearance compared with patients who do not have FN. The purpose of this study was to study therapeutic drug monitoring in patients with FN when the TEIC dosing design was based on the population mean method. Materials and Methods: Thirty-nine FN patients with hematological malignancy were included in the study. To calculate the predicted blood concentration of TEIC, we used the two population pharmacokinetic (population PK) parameters (parameters 1 and 2) reported by Nakayama et al. and parameter 3, which is a modification of the population PK of Nakayama et al. We calculated the mean prediction error (ME), an indicator of prediction bias, and the mean absolute prediction error (MAE), an indicator of accuracy. Furthermore, the percentage of predicted TEIC blood concentration within 25% and 50% of the measured TEIC blood concentration was calculated. Results: The ME values were −0.54, −0.25, and −0.30 and the MAE values were 2.29, 2.19, and 2.22 for parameters 1, 2, and 3, respectively. For all of the three parameters, the ME values were calculated as minus values, and the predicted concentrations tended to be biased toward smaller values relative to the measured concentrations. Patients with serum creatinine (Scr) < 0.6 mg/dL and neutrophil counts < 100/μL had greater ME and MAE values and a smaller percentage of predicted TEIC blood concentration within 25% of measured TEIC blood concentrations compared with other patients. Conclusions: In patients with FN, the accuracy of predicting TEIC blood concentrations was good, with no significant differences between each parameter. However, patients with a Scr < 0.6 mg/dL and a neutrophil count < 100/μL showed slightly inferior prediction accuracy.
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spelling pubmed-101451052023-04-29 Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia Takigawa, Masaki Tanaka, Hiroyuki Suwa, Junichi Obara, Tomoya Maeda, Yohei Sato, Mamoru Shimazaki, Yoshitomo Onoda, Toshihisa Ishigami, Akihito Ishii, Toshihiro Medicina (Kaunas) Article Background and Objectives: Teicoplanin (TEIC) is an effective drug for patients with febrile neutropenia (FN); however, it has been reported that these patients may have increased TEIC clearance compared with patients who do not have FN. The purpose of this study was to study therapeutic drug monitoring in patients with FN when the TEIC dosing design was based on the population mean method. Materials and Methods: Thirty-nine FN patients with hematological malignancy were included in the study. To calculate the predicted blood concentration of TEIC, we used the two population pharmacokinetic (population PK) parameters (parameters 1 and 2) reported by Nakayama et al. and parameter 3, which is a modification of the population PK of Nakayama et al. We calculated the mean prediction error (ME), an indicator of prediction bias, and the mean absolute prediction error (MAE), an indicator of accuracy. Furthermore, the percentage of predicted TEIC blood concentration within 25% and 50% of the measured TEIC blood concentration was calculated. Results: The ME values were −0.54, −0.25, and −0.30 and the MAE values were 2.29, 2.19, and 2.22 for parameters 1, 2, and 3, respectively. For all of the three parameters, the ME values were calculated as minus values, and the predicted concentrations tended to be biased toward smaller values relative to the measured concentrations. Patients with serum creatinine (Scr) < 0.6 mg/dL and neutrophil counts < 100/μL had greater ME and MAE values and a smaller percentage of predicted TEIC blood concentration within 25% of measured TEIC blood concentrations compared with other patients. Conclusions: In patients with FN, the accuracy of predicting TEIC blood concentrations was good, with no significant differences between each parameter. However, patients with a Scr < 0.6 mg/dL and a neutrophil count < 100/μL showed slightly inferior prediction accuracy. MDPI 2023-04-13 /pmc/articles/PMC10145105/ /pubmed/37109716 http://dx.doi.org/10.3390/medicina59040758 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Takigawa, Masaki
Tanaka, Hiroyuki
Suwa, Junichi
Obara, Tomoya
Maeda, Yohei
Sato, Mamoru
Shimazaki, Yoshitomo
Onoda, Toshihisa
Ishigami, Akihito
Ishii, Toshihiro
Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title_full Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title_fullStr Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title_full_unstemmed Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title_short Accuracy of Therapeutic Drug Monitoring of Teicoplanin at the Onset of Febrile Neutropenia
title_sort accuracy of therapeutic drug monitoring of teicoplanin at the onset of febrile neutropenia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145105/
https://www.ncbi.nlm.nih.gov/pubmed/37109716
http://dx.doi.org/10.3390/medicina59040758
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