-Case Reports-

Therapeutic Drug Monitoring Simulator for Antibiotic Dosage for Methicillin-Resistant Staphylococcus aureus Sepsis in a Patient with Primary Immunodeficiency on Peritoneal Dialysis

Hidehiko Narazaki¹, Yusuke Terada¹, Kiyohiko Kaizu¹, Toyo Jitsukawa^2,3, Yasuhiko Ito¹ and Takeshi Asano¹

¹Department of Pediatrics, Nippon Medical School, Tokyo, Japan
²Department of Pharmacy, Nippon Medical School, Chiba Hokuso Hospital, Chiba, Japan
³Division of Infection Control and Prevention, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan

Bacterial infections often cause fatal systemic infections in patients with primary immunodeficiency. To prevent unfortunate results, the selection, dose, and dosage of antibiotics are extremely important. Here, we report a case of Wiskott-Aldrich syndrome in a patient undergoing peritoneal dialysis because of chronic renal failure in whom methicillin-resistant Staphylococcus aureus sepsis developed. Because of the primary disease and complications, teicoplanin was the only chosen anti-S. aureus drug to prevent side effects. We used parameter estimation and dosage adjustment from a therapeutic drug monitoring simulation software program to overcome the challenges with teicoplanin treatment.

J Nippon Med Sch 2017; 84: 177-182

Keywords
drug monitoring, primary immunodeficiency disorders, methicillin-resistant Staphylococcus aureus, sepsis, peritoneal dialysis

Correspondence to
Hidehiko Narazaki, MD, PhD, Department of Pediatrics, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
nara@nms.ac.jp

Received, November 13, 2015
Accepted, May 17, 2016