Drug reference

Teicoplanin

Glycopeptide · Antibiotic

GlycopeptideAntibioticATC null

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

FDA category + note

Mechanism

Teicoplanin is a glycopeptide antibiotic that, like vancomycin, binds with high affinity to the D-Ala-D-Ala terminus of peptidoglycan precursor units, blocking both transglycosylation and transpeptidation steps of cell wall synthesis. However, teicoplanin has an exceptionally long half-life (45-70 hours) due to high protein binding (90-95%) and tissue distribution, permitting once-daily or even thrice-weekly dosing after loading — a major practical advantage over vancomycin which requires twice-daily infusions.

Indications

Antibacterial prophylaxis for operations on stomach or oesophagus in patients at high risk of meticillin-resistant Staphylococcus aureusAntibacterial prophylaxis for open biliary surgery in patients at high risk of meticillin-resistant Staphylococcus aureusAntibacterial prophylaxis for resections of colon and rectum for carcinoma, resections in inflammatory bowel disease, and appendicectomy in patients at high risk of meticillin-resistant Staphylococcus aureusBiliary complications following liver transplantationenterococcal endocarditis (along with gentamicin)MRSA infectionspenicillin resistant streptococcal infectionsosteomyelitissurgical prophylaxis (as alternative to vancomycin)

Dosing

Adult: Serious infections: 6 mg/kg IV every 12h for 3 doses, then 6 mg/kg OD. Endocarditis/bone: 12 mg/kg every 12h for 3-5 doses, then 12 mg/kg OD. Surgical prophylaxis: 400 mg single dose.
Renal adjustment: dose needs to be reduced in renal insufficiency