Population pharmacokinetics of teicoplanin in hospitalized elderly patients using cystatin C as an indicator of renal function

Hidefumi Kasai, Yasuhiro Tsuji, Yoichi hiraki, Moeko Tsuruyama, Hideto To, Yoshihiro Yamamoto

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Objective: Serum cystatin C (CysC) has recently been proposed as an alternative marker to serum creatinine (SCR) for estimating renal clearance. In the present study, we performed a population pharmacokinetic analysis of teicoplanin (TEIC), which is mainly eliminated through the kidneys, using CysC as a predictor for renal clearance. Methods: Thirty-six patients with MRSA infections who were administrated to the National Hospital Organization Beppu Medical Center between January 2012 and December 2013 were enrolled and gave 123 sets of blood TEIC concentration data. Renal clearance was estimated by the Hoek equation using CysC, by creatinine clearance predicted by the Cockcroft-Gault equation using SCR, or directly by CysC. One compartment open model with inter-individual variabilities for renal clearance and the volume of distribution as well as an additional residual error model was used to estimate population pharmacokinetic parameters for TEIC. Results: The model with the best predictability was that with CysC as a predictor for renal clearance; it showed better significance than the models using estimated the glomerular filtration rate by the Hoek equation or CLcr. The final model was as follows: CL (L/hr) = 0.510 × (CysC/1.4)−0.68 × Total body weight/600.81, omega (CL) = 19.8% CV, VC (L) = 78.1, omega (V) = 42.7% CV. Conclusion: The present results show the usefulness of CysC to more accurately predict the pharmacokinetics of drugs mainly eliminated through the kidneys, such as TEIC. However, since the sample size in this study was relatively small, further investigations on renal clearance predictability using CysC are needed.

Original languageEnglish
Pages (from-to)284-291
Number of pages8
JournalJournal of Infection and Chemotherapy
Issue number4
Publication statusPublished - 2018 Apr
Externally publishedYes


  • Cystatin C
  • Hoek equation
  • Methicillin-resistant Staphylococcus aureus
  • Pharmacokinetics
  • Teicoplanin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases


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