Penetration of teicoplanin into heart valves and subcutaneous and muscle tissues of patients undergoing open-heart surgery

Penetration of teicoplanin into serum, heart valves, and subcutaneous and muscle tissues was determined in 22 patients undergoing open-heart surgery. Each patient received 12 mg of teicoplanin per kg of body weight as a 30-min intravenous infusion preoperatively. Within 10 h, serum concentrations of teicoplanin declined from 43.1 to 2.8 mu g/ml. Teicoplanin concentrations in subcutaneous tissues reached their peak of 9.2 mu g/g after 2 to 3 h and decreased slowly to 2.3 mu g/g after 9 to 10 h. Concentrations in muscle decreased from 8.7 mu g/g to nondetectable levels. Teicoplanin concentrations in cardiac valvular tissue reached their peak of 6.1 mu g/g and decreased thereafter to 1.7 mu g/g. Teicoplanin concentrations in heart valves were high enough to inhibit methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, which are known to cause postoperative wound infections and infective endocarditis.