New test: Teicoplanin Assay
New test: Teicoplanin Assay
Viapath has added teicoplanin to the repertoire of assays offered by the Therapeutic Drug Monitoring (TDM) laboratory based at King’s College Hospital.
What is Teicoplanin?
Teicoplanin (Targocid, Sanofi-Aventis) is a glycopeptide antibiotic used in the prophylaxis and treatment of serious infections caused by Gram-positive bacteria, including multi-resistant staphylococci. However, there are reports of Staphylococcus aureus with reduced susceptibility to glycopeptides and increasing reports of glycopeptide-resistant enterococci. Teicoplanin is similar to vancomycin, but has a significantly longer duration of action, allowing once daily administration after the loading dose. Teicoplanin is available in oral, intravenous, or intramuscular preparations.
Why is Teicoplanin measured?
Plasma/serum teicoplanin concentrations are not measured routinely because a relationship between plasma/serum concentration and toxicity has not been established. However, monitoring the teicoplanin concentration can be used to optimise treatment in individuals with severe sepsis or burns, deep-seated staphylococcal infection (including bone and joint infection), or endocarditis. Pre-dose (‘trough’) concentrations should be greater than 15 mg/L (greater than 20 mg/L in endocarditis or deep-seated infection such as bone and joint infection), but less than 60 mg/L.
How is Teicoplanin measured?
Teicoplanin is measured on an automated analyser, the Indiko Plus (ThermoFisher Scientific). The teicoplanin assay is a homogeneous particle-enhanced turbidimetric immunoassay and is based on competition between the drug in the sample and the drug coated onto a microparticle for antibody binding sites of the teicoplanin antibody reagent. The teicoplanin-coated microparticle reagent is rapidly agglutinated in the presence of the anti-teicoplanin antibody reagent and in the absence of any competing drug in the sample. The rate of absorbance change is measured photometrically. When a sample containing teicoplanin is added, the agglutination reaction is partially inhibited, slowing down the rate of absorbance change. A concentration-dependent classic agglutination inhibition curve can be obtained with maximum rate of agglutination at the lowest teicoplanin concentration and the lowest agglutination rate at the highest teicoplanin concentration (Figure 1).
2 mL EDTA whole blood or 1 mL plasma or serum is required for analysis. Ideally samples should be taken pre-dose (a ‘trough’ sample).
Turn-around time is 5 working days.
Further information on requesting a teicoplanin assay, including a downloadable request form, can be found on the Viapath website:
For additional details on teicoplanin, please email:
kch-tr [dot] toxicology [at] nhs [dot] net
- Darley E.S.R. and MacGowan A.P. (2004) The use and therapeutic drug monitoring of teicoplanin in the UK. Clinical Microbiology and Infection 10: 62-69.
- MacGowan AP. (1998) Pharmacodynamics, pharmacokinetics, and therapeutic drug monitoring of glycopeptides. Therapeutic Drug Monitoring. 20: 473-477.