Teicoplanin is a glycopeptide antibiotic, structurally and functionally similar to vancomycin, used for the treatment of serious Gram-positive bacterial infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA) and other resistant organisms. It is considered a second-line or alternative agent to vancomycin, often preferred in certain Indian clinical scenarios due to its once-daily dosing and potentially more favorable safety profile regarding nephrotoxicity and 'Red Man Syndrome'.
Adult: Loading Dose: 400 mg IV every 12 hours for 3 doses. Maintenance Dose: 400 mg IV or IM once daily. For severe infections (e.g., endocarditis, osteomyelitis): Maintenance dose may be increased to 400 mg every 12 hours.
Note: For IV use: Reconstitute 400mg vial with 3-4 mL of Water for Injections. Further dilute in 100-250 mL of compatible IV fluid (0.9% NaCl, 5% Dextrose, Ringer's Lactate). Infuse over 30 minutes. For IM use: Reconstitute with 3 mL of 1% Lidocaine HCl (without adrenaline) or Water for Injections. Administer by deep intramuscular injection. DO NOT administer IV push.
Teicoplanin inhibits bacterial cell wall synthesis by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units (lipid II). This binding prevents the incorporation of these subunits into the peptidoglycan matrix by inhibiting the transglycosylation step, a crucial process for cell wall cross-linking and rigidity.
Pregnancy: Category C (US FDA). Animal studies have shown fetal toxicity. Use only if the potential benefit justifies the potential risk to the fetus. Should be prescribed by a specialist.
Driving: May cause dizziness or vertigo. Patients should be cautioned about operating machinery or driving until they know how teicoplanin affects them.
| Aminoglycosides (Gentamicin, Amikacin) | Increased risk of nephrotoxicity and ototoxicity. | Major |
| Loop Diuretics (Furosemide) | May potentiate ototoxicity. | Moderate |
| Other Nephrotoxic drugs (Amphotericin B, Cisplatin) | Additive risk of kidney damage. | Major |
| Warfarin | Potential increased anticoagulant effect; monitor INR closely. | Moderate |
| Ceftriaxone (in neonates) | Risk of precipitation in bile; avoid concomitant use in neonates. | Major |