The evaluation of factors affecting teicoplanin trough level through therapeutic drug monitoring in adult patients hospitalized in anesthesiology and reanimation intensive care unit

Aim: The purpose of this thesis was to evaluate the proportion of critically ill patients hospitalized in the anesthesiology and reanimation intensive care unit who reached the specified teicoplanin trough level and the factors hypothesized to influence attaining this trough level. Material and Method: This prospective study was conducted between May 9, 2022 and January 27, 2023 at the Inonu University Turgut Ozal Medical Center Reanimation ICU and between May 1, 2023 and July 21, 2023 at the Erciyes University Faculty of Medicine Hospitals Anesthesia ICU. During teicoplanin treatment; daily demographic data, laboratory data, daily vital signs of patients, daily medication order lists, and teicoplanin infusion information were gathered, and the statistical relationship between teicoplanin trough level and these characteristics was studied. The trough level of plasma teicoplanin was determined by LC/MS-MS and the target level was determined to be 10 mg/L. While continuous data are expressed as median [25. percentile – 75th percentile], categorical data are expressed as numbers (percentage). Results: A total of 20 patients over the age of 18 were included in the study, and the median age of the patients was found to be 70 [55.25-73.00]. The median unit dose of teicoplanin administered to the patients was found to be 5.52 [4.51-6.04] mg/kg, and it was shown that 50% of the patients reached the target teicoplanin trough level with this dose. It was observed that the erythrocyte, hemoglobin, and hematocrit values of teicoplanin decreased significantly at the end of the treatment compared to the pre-treatment (p<0.05). Teicoplanin-induced hepatotoxicity, thrombocytopenia, and an increase in serum creatinine values were also examined, but no significant change was found (p>0.05). Conclusion: In this thesis, it has been shown that the target level of teicoplanin is reached in a considerable part of the patients with a unit dosing of less than 6 mg/kg in the intensive care population. The reason for this is thought to be the kidney functions of the patients. More studies with a larger sample size in which clinical pharmacists take a role are needed to more clearly reveal the risk factors that may have an effect on the teicoplanin trough level and teicoplanin-induced adverse effects.