Teicomix (Teicoplanin)
Teicoplanin is a glycopeptide antibiotic used in the prophylaxis & treatment of serious infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis & clostridium difficile.
It's mechanism of action is to inhibit bacterial cell wall synthesis by inhibiting the formation of peptidoglycan.
Teicomix® indications:
- Hospital acquired pneumonia & community acquired pneumonia - Infective endocarditis
- Complicated skin & soft tissue infections
- Bone & joint infections
- Complicated urinary tract infections
- Peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD)
- As antimicrobial prophylaxis in orthopedic surgery at risk of Gram-positive infection (MRSA)
- Bacteremia that occurs in association with any of the indications listed above
- As alternative oral treatment for Clostridium difficile infection-associated diarrhea & colitis.
dosing in adults and elderly patients with normal renal function
| Indications | Loading dose | Maintenance dose |
| - Complicated skin and soft tissue infections - Pneumonia - Complicated urinary tract infections | 6 mg/kg body weight every 12 hrs for 3 IV or IM administrations | 6 mg/kg body weight IV or IM once a day |
| - Bone and joint infections | 12 mg/kg body weight every 12 hrs for 3 to 5 IV administrations | 12 mg/kg body weight IV or IM once a day |
| - Infective endocarditis | 12 mg/kg body weight every 12 hrs for 3 to 5 IV administrations | 12 mg/kg body weight IV or IM once a day |
| - Peritonitis for patients on continuous ambulatory peritoneal dialysis (CAPD) | 6 mg/kg body weight IV as single injection | first week: 20 mg/L in each dialysis bag second week: 20 mg/L in every other dialysis bag third week: 20 mg/L in the overnight dialysis bag |
| - Clostridium difficile infections | 100 to 200 mg by mouth, twice a day for 7 to 14 days |
Teicomix® dosing in babies & childrens
| Age range | Loading dose | Maintenance dose |
| Babies (from birth to the age of 2 months) | 16 mg/kg body weight as IV infusion through a drip, on the first day | 8 mg/kg body weight as IV infusion through a drip once a day |
| Children (from 2 months to 12 years) | 10 mg/kg body weight every 12 hrs IV administrations, repeated 3 times | 6-10 mg/kg body weight IV administration, once a day |
Specific advantages:
| Teicoplanin Vs. Vancomycin |
| Characteristics | Teicoplanin | Vancomycin |
| Dosing frequency | Once daily(longer t1/2) | More than once daily |
| Nephrotoxicity | less | more |
| Infusion time | less | more |
| Dose adjustment in renal dysfunction* | Less needed-Simple | More needed-Difficult |
| Dose adjustment in elderly population | No | Yes |
| Hypersensitivity reactions (red man syndrome) | Less | More |
*In renal dysfunction, usual dose is used for first three days. After the fourth day of treatment: In mild and moderate renal insufficiency (creatinine clearance 30-80 mL/min): maintenance dose should be halved, either by administering the dose every two days or by administering half of this dose once a day. - In severe renal insufficiency (creatinine clearance less than 30 mL/min) and in haemodialysed patients: dose should be one-third the usual dose, either by administering the initial unit dose every third day or by administering one-third of this dose once a day. 
