Thrice-weekly teicoplanin: an old drug for modern needs. Experience of its use as outpatient parenteral antibiotic therapy (OPAT) at infectious disease unit of Manzoni hospital (Lecco)

Teicoplanin is a glycopeptide antibiotic with a long elimination half-life (50 hours) that allows administration thrice a week, though it is approved for daily use. The aim of this retrospective, single-arm study is to assess the clinical outcome of using thrice-weekly teicoplanin (TWT) as outpatient parenteral antibiotic therapy (OPAT) for deep (DSIs) and non-deep-seated infections (NDSIs). We included 37 outpatients (25 with DSIs and 12 with NDSIs) treated with TWT between 01/2021 and 10/2023. The outcome was favorable in 78% of them (80% with DSI, 75% with NDSIs) and Therapeutic drug monitoring (TDM) was performed in all cases. 8 patients required dosage modification because of inadequate trough levels; they were younger and had a higher creatinine clearance. 6/37 patients experienced adverse events, mostly skin rash (4/6). TWT can be a good option for OPAT; its pharmacokinetic reduces the number of hospital accesses and TDM permits to tailor the dosage.