Abstract

MARTINEZ-ROMERO, GJ; NAGORE GALLEGO, MD; GOMEZ MARIN, R  and  SERRANO OLAIZOLA, A. Pharmacokinetic monitoring in ambulatory treatment with teicoplanin for chronic knee prosthetic infection. Rev. OFIL·ILAPHAR [online]. 2020, vol.30, n.3, pp.253-255.  Epub Apr 05, 2021. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2020000300017.

We report a patient with chronic knee prosthetic infection, underwent multiple surgical procedures and previous antibiotic treatments. Traumatologist indicated chronic suppressive antibiotic treatment and no further surgery was indicated due to the patient´s high comorbidity. A microbiology examination revealed the presence of hetero-resistant Staphylococcus epidermidis strains, which meant the possibility of being treated only with linezolid or glycopeptides. It was discarded a chronic use of linezolid due to reasons of hematological toxicity and optical and peripheral neuropathy described in treatments over 28 days. Teicoplanin was proposed for good pharmacokinetic profile, which makes it optimal for outpatient management regimes. Monitoring of treatment was based on the pharmacokinetics monitoring teicoplanin trough levels, and dose adjustment based on them. Monitoring inflammation parameters, hematology and renal function was performed to monitor the effectiveness and toxicity of treatment. During the follow-up period (18 months) patient presented a satisfactory clinical evolution without notable toxicity. In this sense, in selected patients, teicoplanin with outpatient management may be useful in treating chronic infections of joint prosthesis.

Keywords : Teicoplanin; pharmacokinetic monitoring; prosthetic infection.

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