Teicoplanin

Targocid

Teicoplanin is a glycopeptide antibiotic in the same family as vancomycin, produced by the bacterium Actinoplanes teichomyceticus. Like vancomycin, it works by binding the D-alanyl-D-alanine terminus of the peptidoglycan precursors that bacteria use to assemble their cell wall, blocking the cross-linking steps and preventing the organism from building a stable envelope. Its spectrum is therefore Gram-positive: staphylococci (including methicillin-resistant Staphylococcus aureus), streptococci, enterococci, and other Gram-positive pathogens. It shares vancomycin's inability to cross the Gram-negative outer membrane. What distinguishes teicoplanin in practice is its pharmacology. It is more lipophilic and highly protein-bound, giving it a much longer half-life than vancomycin. That allows a loading-dose strategy followed by once-daily — or in some settings even less frequent — maintenance dosing, and it can be given by intramuscular injection as well as intravenously, which can simplify outpatient and community treatment. Infusion-related flushing reactions are generally less of an issue than with fast vancomycin infusions. Teicoplanin is a well-established, approved prescription antibiotic in the European Union, the United Kingdom, Australia, and many other countries (brand name Targocid), and it is not marketed in the United States. Therapeutic drug monitoring is used for serious or deep-seated infections to ensure adequate exposure, and dosing is adjusted for kidney function. As with all glycopeptides, appropriate use matters for preserving activity against resistant Gram-positive organisms. It is a hospital-and-specialist antibiotic used under medical supervision, not a consumer or research peptide.