Teicoplanin and therapeutic drug monitoring: An update for optimal use in different patient populations

Individualization of antimicrobial treatment based on real-time therapeutic drug monitoring (TDM) and dosing adaptation may represent an important tool in the antimicrobial stewardship programs. Teicoplanin is a glycopeptide hydrophilic antibiotic whose pharmacokinetic behavior may consistently vary among different patient populations. Nowadays it is generally recognized that the effective trough (Cmin) plasma level of tecoplanin should be of at least 10–15 mg/L for the treatment of mild infections, and of 15–30 mg/L for the treatment of deep-seated infections and/or of severe infections. The aim of this viewpoint is to provide an update for optimal use of teicoplanin TDM in different patient populations. Available literature supports TDM of Cmin as a helpful approach in addressing appropriate treatment with teicoplanin, with a frequency of assessment that should be guided by the severity of the infection and/or by the complexity of the pathophysiological status of the patient.