Teicoplanin - Uses, Dosage, Side Effects, Drug Warnings, and Precautions

Overview:

Teicoplanin, a semisynthetic glycopeptide antibiotic, is used in the prevention and treatment of severe bacterial infections, such as Enterococcus faecalis and methicillin-resistant Staphylococcus aureus and and infections caused by other resistant gram-positive bacteria. Its spectrum of activity is similar to that of Vancomycin. This antibiotic works by inhibiting bacterial cell wall synthesis. Teicoplanin is commercially available in the trade name Targocid and Ticocin. The oral solution is only effective in treating Clostridium difficile-associated diarrhea and pseudomembranous colitis. In patients with kidney diseases, Teicoplanin can increase the risk of severe adverse effects.

Inform your doctor immediately if you develop symptoms of allergic reactions, such as skin rash, nausea, hives, facial swelling, etc., after taking this antibiotic. Avoid using this medicine if you suffer from hypersensitivity, and if you are pregnant or breastfeeding.

Drug Group:

As mentioned earlier, Teicoplanin is a semisynthetic glycopeptide antibiotic and is made up of various compounds, which are:

1. Five major - Teicoplanin A2-1 to A2-5.

2. Four minor - Teicoplanin RS-1 to RS-4.

This antibiotic is extracted from Actinoplanes teichomyceticus, which is also used to produce Acarbose (an antidiabetic drug), Validamycin (antibiotic fungicide), and Ramoplanin (antibiotic). Examples of other glycopeptide antibiotics are Vancomycin, Telavancin, Decaplanin, Ramoplanin, and Carbomycin.

What Is Teicoplanin Used For?

Teicoplanin is used in the treatment of:

1. Hospital-acquired pneumonia - Lung infection caused by gram-positive bacteria.

2. Skin infections - Complicated skin and soft tissue infections caused by gram-positive bacteria, such as abscesses, infected wounds, folliculitis, ulcers, cellulitis, etc.

3. Urinary tract infection - Severe infections in the urinary system by gram-positive bacteria.

4. Infective endocarditis - Serious infections of the inner lining of the heart by gram-positive bacteria.

5. Bone and joint infections - Osteomyelitis, infectious arthritis, and other severe bone and joint infections caused by gram-positive bacteria.

6. Peritonitis - Inflammation of the tissue lining the inner wall of the abdomen (peritoneum), commonly seen in patients receiving continuous peritoneal dialysis.

7. Bacteremia - The presence of gram-positive bacteria in the blood.

8. Clostridium difficile-associated diarrhea and colitis - Clostridium difficile, a spore-forming bacteria that causes diarrhea and inflammation of the colon, especially in older adults using broad-spectrum antibiotics for long periods.

Teicoplanin and COVID-19:

With scientists desperately trying to find medicines that can be used to treat COVID-19 (infection caused by the SARS-CoV-2 virus), Teicoplanin has emerged as a potential option. Teicoplanin is said to be 20 times more effective in inhibiting the activity of the enzyme 3CLpro, which is required for viral replication, than other medicines tried on COVID-19 patients, such as Hydroxychloroquine (HCQ), Azithromycin, and Lopinavir.

Teicoplanin's benefits are that it does not have severe side effects like drugs, such as HCQ, which can harm the heart. There is no proof if Teicoplanin is indeed effective, and various drug trials need to be conducted before it gets approved for treating COVID-19.

How Does Teicoplanin Work?

This antibiotic is effective exclusively against gram-positive bacteria. Teicoplanin inhibits peptidoglycan polymerization and protein synthesis, which blocks the bacterial cell wall synthesis, resulting in cell death. Without the synthesis of the cell wall, the bacteria become weak and susceptible.

Onset Of Action:

The time taken for Teicoplanin to start working has not been clinically established. When administered intramuscularly, it has a bioavailability of 90 to 95 %, and the half-life is 100 to 170 hours depending on the patient's kidney functions.

Habit-Forming:

There have been no reports of the habit-forming tendency in people taking Teicoplanin.

Expiry Date:

Avoid taking this medicine after it expires. The expiry date will be printed on the back of the pack.

What Is the Dosage of Teicoplanin?

The dosage of Teicoplanin will be decided by your doctor based on your age, weight, and other medical conditions.

How to Use Teicoplanin?

Teicoplanin, when administered orally, does not get absorbed by the gastrointestinal tract. After a single dose of 250 or 500 mg orally, this medicine does not get detected in the serum or urine, and 45 % is recovered in feces as unchanged medicine. Only for Clostridium difficile-associated diarrhea and pseudomembranous colitis, the oral solution is used.

For all other infections, Teicoplanin is administered intravenously or intramuscularly once daily (6 to 10 mg/kg body weight).

Missed Dose:

If you are taking it orally and you miss a dose, you can take it as soon as you remember about missing the tablet. But if it is already time for the next dose, then do not take two tablets together, resulting in severe adverse reactions. Just skip the missed dose and take the next dosage.

As healthcare professionals administer intravenous and intramuscular injections, it is highly unlikely that you miss a dose. If you still miss a dose, consult your doctor immediately.

Overdose:

In case of overdose with Teicoplanin orally, seek emergency medical treatment. And as medical professionals administer the injection form of this antibiotic, an overdose is unlikely. In case you do develop signs of overdose, the doctor will treat it symptomatically.

What Are the Drug Warnings and Precautions?

There are a few things that need to be considered before taking this tablet, and tell your doctor if you have any of the following conditions:

• Pregnancy - Teicoplanin is not recommended for use in pregnant women unless there is no other treatment option. The doctor will weigh the risks and benefits before prescribing this medicine.

• Breastfeeding - It is not recommended to use this medicine while breastfeeding, unless absolutely necessary. The doctor will weigh the risks and benefits before prescribing this medicine, and you may have to discontinue breastfeeding before starting this therapy.

• Low Platelet Count - Teicoplanin may result in thrombocytopenia, that is, decreased blood platelet count, which is why the doctor will monitor your platelet levels and alter and adjust the dose accordingly.

• Red Man Syndrome - It is a condition similar to an allergy, commonly seen in people taking Vancomycin or Teicoplanin. This syndrome can result in itching, redness, hives, tachycardia (increased heart rate), hypotension (low blood pressure), breathing difficulties, etc. This reaction can be treated by stopping or slowing the rate of infusion, or replacement with a suitable alternative.

• Drug Resistance - This medicine should only be used after the cause is diagnosed to be a gram-positive bacterial infection. Indiscriminate use might make bacteria resistant to Teicoplanin.

• Kidney Impairment - Patients with a history of kidney diseases should use this medicine with caution due to the increased risk of side effects.

• Avoid Driving - Teicoplanin can result in dizziness, so avoid driving or operating heavy machinery while on treatment with this drug.

What Are the Side Effects of Teicoplanin?

The common side effects of Teicoplanin are:

1. Rashes.

2. Fever.

3. Pruritus.

4. Diarrhea.

5. Nausea.

6. Vomiting.

The less common and severe side effects include:

1. Ototoxicity (toxic to the ear).

2. Altered liver function.

3. Leucopenia (decreased white blood cells).

4. Thrombocytopenia (decreased platelet count).

5. Hypersensitivity (allergies).

6. Impaired renal function.

What Are the Interactions of Teicoplanin?

It is natural for all drugs to interact with other drugs, food, and supplements. This interaction can result in certain unwanted side effects. The common interactions of Teicoplanin are:

• With medicine

  • Amphotericin B.

  • Cisplatin.

  • Cyclosporine.

  • Aminoglycoside antibiotics.

  • Furosemide.

The interaction between Teicoplanin and alcohol, lab tests, and food is not available.

What Are the Common Brand or Trade Names of Teicoplanin?

1. Invictum 400 mg Injection.

2. T Planin 200 mg Injection.

3. Teicobiotic 400 mg Injection.

4. Ticocin 200Mg Injection.

5. T Planin 400 mg Injection.

6. Trueplan 400 mg Injection.

7. Ticovan 400 mg Injection.

8. Ticocin 400 mg Injection.

9. Troyplanin 400 mg Injection.