Introduction
Teicoplanin is a glycopeptide antibiotic developed after vancomycin for the treatment of Gram-positive (G+) cocci. Due to the chemical structure of fatty acid side chains, the relative molecular mass is increased, so in pharmacokinetics, it shows good characteristics, strong tissue penetration, cell concentration, protein binding rate of more than 90%, and a significant increase in half-life. In addition to intravenous administration, it can also be intramuscularly injected. In vitro antibacterial activity Teicoplanin is similar to vancomycin and sensitive to VanB and VanC in vancomycin-resistant Enterococcus.
Pharmacologic action
Glycopeptide antibacterial drugs have good antibacterial activity against Gram-positive bacteria. Teicoplanin and vancomycin belong to glycopeptide antibacterial drugs. The basic skeleton of teicoplanin structure is similar to vancomycin, and is closely related to the complex composed of glycopeptides. Due to the unique acetyl substituent, the lipophilicity is 30 to 100 times of vancomycin, and can penetrate into tissues and cells more easily. Teicoplanin binds to amino-D-alanyl-D-alanine at the end of the bacterial wall peptidoglycan precursor of the lytic sensitive bacteria. Blocking the synthesis of the cell wall destroys the integrity of the cell wall and cell membrane, thereby inhibiting and killing bacteria.
Treatment methods and observation indicators
Empirical treatment is based on clinical judgment and has been determined to be associated with multiple bacterial infections against Gram-negative (G+) bacilli or against other established pathogens. Once the pathogen diagnosis is clear, the treatment plan should be adjusted according to the pathogen and drug sensitivity as soon as possible. Clinical symptoms and signs are recorded daily. Blood and urine routine and liver and kidney function and bacteriological follow-up will also be recored before and after treatment. Chest X-rays are taken before and after treatment of lower respiratory tract infection.
Safety evaluation
Teicoplanin has a high plasma protein binding rate, high bioavailability, low incidence of adverse reactions, and a nephrotoxicity rate of zero. In the report on other adverse reactions of glycopeptide antibacterial drugs, it is worth noting that it causes skin adverse reactions, mainly rash and itching. Some scholars believe that the use of glycopeptide antibacterial drugs for Gram-positive bacteria in abdominal cavity infection can lead to a decrease in sensitivity, which ultimately leads to drug resistance.
References:
1. Zu Yuna, Xu Aiguo. Teicoplanin and Vancomycin in Treatment of Severe Gram-positive Bacterial Infections: A Clinical Evaluation. The first af filiated hospital, Zhengzhou University, Zhengzhou, Henan 450052, China.
2. He Lixian, PanJue, Chen Shiyao, Wang Aixia, Xie Canmao, Shen Zhengyi. Clinical study of teicoplanin in the treatment of patients with gram-positive cocci. Department of respiratory medicine, Zhongshan hospital, Fudan University, Shang hai 200032.
