Homogeneous Immunoassays—Therapeutic Drug Monitoring
Innofluor®—Fluorescence Polarization Immunoassays To view and print the files below you will need Adobe Acrobat Reader®,
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INNOFLUOR® Teicoplanin Assay System
The INNOFLUOR® TEICOPLANIN Assay System is intended for the quantitative determination of total teicoplanin in serum for therapeutic drug monitoring by fluorescence polarization immunoassay (FPIA). The assay system is for use on the TDx® or the TDxFlxTM (TDx®/TDxFLx®) analyzer.
Teicoplanin is a glycopeptide antibiotic complex of the vancomycin-ristocetin, structurally related to vancomycin that both contain a heptapeptide backbone.1,2 Like vancomycin, teicoplanin inhibits cell-wall biosynthesis by interfering with peptidoglycan synthesis in gram-positive bacteria.3 Teicoplanin is indicated for the treatment of moderate to serious infections caused by susceptible strains of bacteria such as staphylococci, streptococci, enterococci, bacilli and diphtheroids.4
Teicoplanin is normally more than 90% protein bound in circulation and exhibits protein-binding dependent elimination.5 the majority of teicoplanin is excreted unaltered in the urine. In subjects with normal renal function, teicoplanin administered intravenously as a single dose has a circulation half-life in excess of 150 hours.6 Urinary elimination of teicoplanin decreases with renal impairment.7,8 In addition, wide inter-individual variation in clearance rate has been reported with renal impairment, especially in critically ill patients.7-9 Patients with a history of intravenous drug abuse and bum patients have shown wide variations in pharmacokinetic parameters between individuals.10,11
Since pharmacokinetics of teicoplanin may not correlate with renal function and there are wide variations between individuals, monitoring of serum levels of teicoplanin has been recommended as a means of determining the appropriate dosage regimen and to facilitate dosage adjustment.8-12 Bioassay and HPLC have been used previously to quantitate circulating serum levels of teicoplanin.13-16
Hunt AH, Molloy RM, Occolowitz JL, Marconi GG, Debono M. Structure of the major glycopeptide of the teicoplanin complex. J Am Chem Soc 1984; 106: 4891-4895.
Parenti F. Structure and mechanism of action of teicoplanin. J Hosp Infect 1986; 7[suppl A]: A79-83.
Somma S, Gastaldo L, Corti A. Teicoplanin, a new antibiotic from actinoplanes teichomyceticus nov. sp. Antimicrob Agents Chemother 1984; 26(6): 917-923
Personal communication with Eric W. Lewis, M.D., Marion Merrill Dow Inc., Kansas City, MO U.S.A.
Assandri A, Bernareggi A. Binding of teicoplanin to human serum albumin. Eur J Clin Pharmacol 1987; 33: 191-195.
Antony KK, Lewis EW, Kenny MT, Dulworth JK, Brackman MB, Kuzman R, Yuh L, Eller MG, Thompson GA. Pharmacokinetics and bioavailabilitty of a new formulation of teicoplanin following intravenous and intramuscular administration to humans. J Pharm Sciences 1991; 80(60): 605-607.
Falcoz C, Ferry N, Pozet N, Cuisinaud G, Zech PY, Sassard J. Pharmacokinetics of teicoplanin in renal failure. Antimicrob Agents Chemother 1987; 31(8): 1255-1262.
Derbyshire N, Webb DB, Roberts D, Glew D, Williams JD. Pharmacokinetics of teicoplanin in subjects with varying degrees of renal function. J Antimicrob Chemother 1989; 23(6): 869-876.
Domart Y, Pierre C, Claire B, Garaud JJ, Regnier B, Gilbert C. Pharmacokinetics of teicoplanin in critically ill patients with various degrees of renal impairment. Antimicrob Agents Chemother 1987; 31(10): 1600-1604.
Potel G, Moutet J, Bemareggi A, Lenormand Y, Meigner M, Baron D. Pharmacokinetics of teicoplanin in bum patients. Sacand J Infect Dis 1990; 72[suppl]: 29-34.
Rybak MJ, Lerner SA, Levine DP, Albrecht LM, McNeil PL, Thompson GA, Kenny MT, Yuh L. Teicoplanin pharmacokinetics in intravenous drug abusers being treated for bacterial endocarditis. Antimicrob Agents Chemother 1991; 35(4): 696-700.
Bibler MR, Frame PT, Hagler DN, Bode RB, Staneck JL, Thamlikitkul V, Harris JE, Haregewoin A, Bullock WE Jr. Clinical evaluation of efficacy, pharmacokinetics, and safety of teicoplanin for serious gram-positive infections. Antimicrob Agents Chemother 1987; 31(2): 207-212.
Awni WM, St. Peter WL, Guay DRP, Kenny MT, Matzke GR. Teicoplanin measurement in patients with renal failure: comparison of fluorescence polarization immunoassay, microbiological assay, and high-performance liquid chromatographic assay. Ther Drug Monit 1991; 13(6): 511-517.
Erickson RC, Hildebrand AR, Hoffman PF, Gibson CB. A sensitive bioassay for teicoplanin in serum in the presence or absence of other antibiotics. Diagn Microbiol Infect Dis 1989; 12: 235-241.
Kenny MT, Dulworth JK, Brackman MA, Tomey HL, Gibson CB, Hildebrand AR, Weckbach LS, Staneck JL. Bioassay of teicoplanin in serum containing rifampin or a beta-lactam antibiotic. Diagn Microbiol Infect Dis 1989; 12:449-454.
Riva E, Ferry N, Cornetti A, Cuisinaud G, Gallo GG, Sassard J. Determination of teicoplanin in human plasma and urine by affinity and reversed-phase high-performance liquid chromatography. J Chromatog 1987; 421: 99-110.
