Teicoplanin dosing in obese patients

  • Research type

    Research Study

  • Full title

    Optimising the dosing of Teicoplanin in obese patients

  • IRAS ID

    331324

  • Contact name

    Christopher Darlow

  • Contact email

    cdarlow@liverpool.ac.uk

  • Sponsor organisation

    University of Liverpool

  • Duration of Study in the UK

    0 years, 6 months, 0 days

  • Research summary

    Research Summary
    Teicoplanin is an injectable antibiotic widely used in Liverpool to treat a variety of serious infections such as sepsis, skin and soft tissue infections, and infections of artificial joints such as knee replacements. It is an important and safe antibiotic that kills problematic bacteria such as MRSA. It can be given once a day which means patients do not have to stay in hospital to receive treatment.

    Individuals process teicoplanin in different ways such that from the same dose the amount of effective drug in the blood can be different. We therefore monitor the amount of teicoplanin in the blood a few days into treatment to make sure there are high enough levels for the antibiotic to work effectively, and based on this we can adjust the dose. However, dosing is difficult in obese patients, and the amount in the blood is frequently incorrect, requiring late dose adjustments.

    Data on the dosing of teicoplanin, measured teicoplanin levels in the blood and relevant anonymised physiological/demographic data will be collected as part of a registered service evaluation audit of routine care at the Royal Liverpool Hospital, with NHS clinical governance oversight. We intend to transfer the anonymised data from this audit to the University where researchers can use computer modelling techniques to analyse the data with the aim of producing a computer model that predicts the likely effective doses of teicoplanin needed initially in obese patients, for a planned future follow-up trial of these doses.

    Summary of Results
    Retrospective data was collected from 400 patients receiving the antibiotic teicoplanin. These patients were from four different body weight groups (classified by BMI, or body mass index), with 100 patients in each group. For each patient, data on their age, kidney function, weight and height was collected, alongside details of when they received teicoplanin and measured concentrations of teicoplanin during the course of this.

    The aim of the study was to collect this data in order to build a computer model (a population pharmacokinetic model, or popPK model) that describes how teicoplanin concentrations change in an individual as they have teicoplanin administered. The popPK model will be able to understand how this changes in patients with different body sizes and be able to predict the dosing for individuals to get the correct dose based on their body weight and kidney function. This model has yet to be completed.

  • REC name

    East of Scotland Research Ethics Service REC 2

  • REC reference

    23/ES/0034

  • Date of REC Opinion

    22 Sep 2023

  • REC opinion

    Further Information Favourable Opinion