natgillin/translations-raw huggingface dataset:
• Bakteriæmi/septikæmi/sepsis “Sepsis” er sædvanligvis sekundær til en infektion med et primært infektiøst fokus og kunne derfor ikke godtages som selvstændig indikation, men blev slettet fra listen over indikationer.
As ‘Sepsis' is generally a secondary condition to a primary site infection, it was not considered to be acceptable as a stand-alone indication, and was therefore deleted from the list of indications.
CHMP godtog, at teicoplanin er indiceret til behandling af pneumoni (hospitals- og samfundserhvervet) uden indskrænkning baseret på patogen organisme.
The CHMP agreed that teicoplanin can be indicated for the treatment of pneumonia (hospital acquired and community acquired pneumonia) without restricting its use according to the pathogen.
I den gældende version af EUCAST testbreakpoints for MIC-værdier er resistens-breakpointet for Staphylococcus aureus blevet nedsat til >2 mg/ml for at undgå indberetning af isolater af intermediære glykopeptidresistente Staphylococcus aureus (GISA), da alvorlige infektioner med isolater af GISA ikke kan behandles med forhøjede doser vancomycin eller teicoplanin.
In the current version of EUCAST MIC breakpoints, the resistance breakpoint for Staphylococcus aureus has been reduced to >2 mg/ml to avoid reporting of glycopeptide intermediate resistant Staphylococcus aureus (GISA) isolates, as serious infections with GISA isolates are not treatable with increased doses of vancomycin or teicoplanin.
Da initialdosis påtænkes givet 3-5 gange, anføres det i produktresuméet, at serum-dalkoncentrationerne bør overvåges, når initialdosisregimet er afsluttet.
Since it is proposed that the loading dose should be administered 3 to 5 times, it has been stated in the SmPC that trough serum concentrations should be monitored on completion of the loading dose regimen.
Således viste en Cochranemetaanalyse af randomiserede kontrollerede undersøgelser (RCT) hos voksne og børn med CAPDbetinget peritonitis, at skønt raterne af primært respons og recidiv ikke afveg mellem intraperitoneale (IP) glykopeptidbaserede regimer og regimer med førstegenerations cefalosporiner, var der større sandsynlighed for fuldstændig helbredelse med glykopeptidregimerne, og primært behandlingssvigt var mindre sandsynligt med teicoplanin end med vancomycin (Wiggins et al., 2008)1.
Indeed, in a Cochrane meta-analysis of randomised controlled trials (RCT) in adults and children with CAPD-associated peritonitis, although the primary response and relapse rates did not differ between intraperitoneal (IP) glycopeptide-based regimens compared to first generation cephalosporin regimens, glycopeptide regimens were more likely to achieve a complete cure, and primary treatment failure was less likely to occur with teicoplanin than vancomycin (Wiggins et al. 2008)1.
Teicoplanin er et antibiotikum i glykopeptidgruppen, der fremstilles ved fermentering af Actinoplanes teichomyceticus og har baktericid virkning in vitro mod aerobe og anaerobe grampositive bakterier.
Teicoplanin is a glycopeptide antibiotic produced by fermentation of Actinoplanes teichomyceticus with in-vitro bactericidal activity against aerobic and anaerobic gram-positive bacteria.
Indikationen behandling af infektioner i knogler og led er bibeholdt uden konkret nævnelse af osteomyelitis, septisk arthritis eller infektioner i forbindelse med proteser.
As agreed by the CHMP, the indication for the treatment of bone and joint infections has been maintained without specifically mentioning osteomyelitis, septic arthritis and prosthetic infections.
• Pneumoni og luftvejsinfektioner
• Pneumonia and respiratory tract infections
Produktinformationen blev derfor opdateret, så det aktive stof deklareres kvalitativt og kvantitativt i masseenheder og i IE: Hvert hætteglas indeholder 200 mg (eller 400 mg) teicoplanin, svarende til 200 000 IE (eller 400 000 IE).
The product information was therefore updated to declare the qualitative and quantitative details of the active substance in terms of mass and IU: each vial contains 200mg (or 400) mg teicoplanin equivalent to 200,000 IU (or 400,000 IU).
Skønt der ikke er forelagt farmakokinetiske data, kunne CHMP godtage rationalet om at råde over en bolus som alternativ til en 30 minutter lang infusion for at lette anvendelsen i ambulante omgivelser.
Although no pharmacokinetic evidence has been provided, the rationale for having a bolus alternative to the 30-minute infusion to facilitate use in out-patients settings was considered to be acceptable by the CHMP.
De forelagte undersøgelser til støtte for profylaktisk anvendelse ved hjertekirurgi viste, at teicoplanin ikke var effektivt til forebyggelse af postoperative infektioner.
The studies provided in support of prophylactic use in cardiac surgery suggest that teicoplanin was not effective in preventing post-operative infections.
Virkningen af teicoplanin ved SSTI blev påvist klinisk og bakteriologisk (37,4 % af alle infektionssteder) i undersøgelse EG-87-42 (den europæiske multicenterundersøgelse).
The clinical and bacteriological efficacy of teicoplanin was shown in SSTIs (37.4% of all infection sites) in Study EG-87-42 (European Multicentre Study).
I de fire publicerede undersøgelser i den oprindelige dokumentation rakte dosisregimerne for teicoplanin fra engangsdosering med 6 mg/kg til en initialdosering bestående af tre doser med 10 mg/kg hver 12. time efterfulgt af 10 mg/kg/dag som vedligeholdelsesdosis.
In the four published studies of the initial dossier, the teicoplanin dose regimens across studies ranged from 6 mg/kg unit dose to a loading dose of 10 mg/kg every 12 hours for 3 doses followed by 10 mg/kg daily maintenance dose.
Styrkerne af det færdige produkt indeholdende teicoplanin er deklareret på sædvanlig måde og specificeret i masseenheder (f.eks. 200 mg og 400 mg), men på grund af variabiliteten af det aktive stof afgøres mængden heraf i det færdige produkt ved det færdige produkts styrke, bestemt ved mikrobiologisk assay og angivet i IE (f.eks. 200 000 IE eller 400 000 IE).
The strengths of teicoplanin finished product are conventionally declared and prescribed in terms of mass (e.g. 200 mg and 400 mg), but given the variability of the active substance, it is the potency of the finished product, as determined by microbiological assay and declared in IU (e.g. 200,000 IU or 400,000 IU), that determines the quantitative amount of active substance in the finished product.
Overordnet er de bivirkninger, der er anført i de centrale sikkerhedsoplysninger, som blev aftalt under PSUR-arbejdsdelingsprocedure nr. GR/H/PSUR/0001/001, optaget i punkt 4.8 af det ansøgte harmoniserede produktresumé med anvendelse af de af MedDRA foretrukne betegnelser og inddelt efter systemorganklasse.
Overall, the undesirable effects listed in the CSP agreed during the PSUR work-sharing procedure number GR/H/PSUR/0001/001 have been included in section 4.8 of the proposed harmonised SmPC using the MedDRA Preferred Terms (PTs), and classified by System Organ Class (SOC).
Indehaveren af markedsføringstilladelsen påtænkte en modificeret advarsel om hypersensitivitetsreaktioner med henblik på de indberettede fatale tilfælde og med stærkere fremhævelse af muligheden for krydsallergi over for vancomycin; dette blev godkendt af CHMP.
A modified warning regarding hypersensitivity reactions to address the fatal cases that have been reported and to strengthen the possibility of cross hypersensitivity to vancomycin was proposed by the MAH, and accepted by the CHMP.
Der er ikke udført farmakokinetiske lægemiddelinteraktionsundersøgelser med teicoplanin af indehaveren af markedsføringstilladelsen, og der er ikke fundet data herom i den publicerede litteratur.
No pharmacokinetic drug-drug interaction with teicoplanin has been carried out by the MAH, and no published data have been retrieved from the literature.
I afsnittet om reproduktionstoksicitet er der ændret yderligere i ordlyden som anmodet af CHMP.
Further amendments to the wording of the reproductive toxicity section have been included, as requested by the CHMP.
De forskellige undersøgelser, som blev gennemgået af indehaveren af markedsføringstilladelsen, viser, at teicoplanin har en plads i behandlingen af pneumoni.
The results from the various studies discussed by the MAH suggest that teicoplanin has a place in the management of pneumonia.
Indikationen profylaktisk anvendelse af teicoplanin ved ortopædkirurgi var ikke tilstrækkeligt underbygget.
The indication for the prophylactic use of teicoplanin in orthopaedic surgery was not adequately justified.
Følgende infektioner forårsaget af grampositive mikroorganismer blev gennemgået af CHMP:
Treatment of infections caused by Gram-positive microorganisms The following infections caused by Gram-positive microorganisms were discussed by the CHMP:
Efter vurdering af forslagene fra indehaveren af markedsføringstilladelsen og drøftelserne i udvalget vedtog CHMP afsluttende den harmoniserede produktinformation bestående af produktresumé, etikettering og indlægssedler for Targocid og relaterede navne.
In conclusion, based on the assessment of the proposals submitted by the MAH and the discussions of the Committee, the CHMP adopted the harmonised product information consisting of the summary of product characteristics (SmPC), labelling and package leaflets, for Targocid and associated names.
Det format, der foreslås af indehaveren af markedsføringstilladelsen, er generelt i overensstemmelse med EU's vejledning for produktresuméer og kan derfor godkendes af CHMP.
The general format proposed by the MAH is in accordance with the EU guideline on the SmPC and therefore considered to be acceptable by the CHMP.
Indehaveren af markedsføringstilladelsen har forelagt evidens fra publikationer til støtte for anvendelse af teicoplanin kombineret med andre antimikrobielle stoffer såsom aminoglykosider.
The MAH has provided evidence from publications in support of the use of teicoplanin in combination with other anti-microbial agents such as aminoglycosides.
Hyppighederne af alle de opførte bivirkninger er beregnet på grundlag af data fra interne kliniske undersøgelsesresultater, der blev anvendt i den oprindelige ansøgning, og disse blevet indarbejdet i de centrale sikkerhedsoplysninger under PSUR-arbejdsdelingsprocedure nr. GR/H/PSUR/0001/001, hvilket blev godkendt af medlemsstaterne.
The frequencies of all listed adverse reactions have been calculated using data from in-house clinical trials results used for the original submission, and these were incorporated into the CSP during the PSUR work-sharing procedure number GR/H/PSUR/0001/001, which was accepted by the member states.
Det forelagte harmoniserede dossier omfattede det aktive indholdsstof teicoplanin og produkter, der indeholder dette stof: Targocid, pulver til injektionsvæske/infusionsvæske, opløsning, 100, 200 og 400 mg, og Targocid, pulver og solvens til injektionsvæske/infusionsvæske, opløsning, 100, 200 og 400 mg.
The harmonised dossier was provided for the active substance (teicoplanin) and for products containing this substance: Targocid 100, 200 mg and 400 mg powder for solution for injection/infusion and Targocid 100, 200 mg and 400 mg powder and solvent for solution for injection/infusion.
Den foreslåede ordlyd blev godkendt af CHMP.
The proposed wording was considered to be acceptable by the CHMP.
CHMP godtog oplysningerne om måling af serum-dalkoncentrationerne af teicoplanin med high performance væskekromatografi (HPLC) og fluorescens-polarisations-immunoassay (FPIA).
The information on the measurement of teicoplanin trough serum concentrations by High Performance Liquid Chromatography (HPLC) and Fluorescence Polarization Immunoassay (FPIA) method was considered to be acceptable by the CHMP.
CHMP godtog denne indikation, da det fremgår, at teicoplanin ikke optages fra mave-tarmkanalen i større omfang.
This indication was considered to be acceptable by the CHMP as it appears that teicoplanin is not absorbed to a great extent from the gastro-intestinal tract .
er resistens-breakpointet for teicoplanin nedsat til >2 mg/ml for at undgå fejlagtige indberetning af isolater med vancomycin-A-medieret resistens.
Regarding Enterococcus spp., the resistance breakpoint for teicoplanin has been reduced to >2 mg/ml to avoid erroneous reporting of isolates with Van-A-mediated resistance.
Indehaveren af markedsføringstilladelsen benyttede lejligheden til som led i henvisningsproceduren at harmonisere dossieret vedrørende kvalitet for Targocid og relaterede navne.
The MAH took the opportunity to harmonise the Quality dossier for Targocid and associated names as part of the referral procedure.
Oplysning om den manglende interaktion mellem teicoplanin og andre antibiotika, antihypertensiva, kardiotrope midler, antidiabetika og anæstetika er indeholdt i det foreslåede harmoniserede produktresumé.
Section 4.5- Interaction with other medicinal products and other forms of interaction The lack of interaction between teicoplanin and other antibiotics, antihypertensives, cardiotropic, antidiabetic agents and anaesthetic agents has been included in the proposed harmonised SmPC.
Den kliniske helbredelsesrate var > 80 % på linje med resultaterne i undersøgelserne hos voksne.
In keeping with the adult studies, the clinical cure was > 80%.
Baseret på Monte Carlo-simuleringer udført af Yamada et al2 har indehaveren af markedsføringstilladelsen foreslået en initialdosering med 6 mg/kg to gange dagligt med tre administrationer til de fleste infektioner, og 12 mg/kg to gange dagligt med tre til fem administrationer ved infektioner i knogler og led samt infektiøs endokarditis.
Based on the Monte Carlo simulations conducted by Yamada et al2 the MAH has proposed a loading dose of 6mg/kg bid for 3 administrations for most infections, and 12mg/kg bid for 3 to 5 administrations for bone and joint infections and infective endocarditis.
Den antimikrobielle aktivitet af teicoplanin menes at bero på det tidsrum, hvor dalkoncentrationerne er højere end MIC-værdierne for de givne patogener.
Teicoplanin antimicrobial activity is thought to depend on trough concentrations being higher than MIC of particular pathogens, and also dependent on the duration of time during which trough concentrations remain higher than MIC.
Da urinvejsinfektioner hovedsagelig skyldes gramnegative organismer, anså indehaveren af markedsføringstilladelsen teicoplanins rolle for at være begrænset ved urinvejsinfektioner.
Considering that UTIs are mainly caused by gramnegative infections, the MAH was of the view that teicoplanin has a limited role in the management of UTIs.
Indehaveren af markedsføringstilladelsen har fremført, at dalkoncentrationerne ved de fleste infektioner bør holdes på 10 mg/l (målt med high performance væskekromatografi), og at der bør tilstræbes højere koncentrationer på 15-30 mg/l ved svære infektioner såsom endokarditis, septisk arthritis og osteomyelitis.
The MAH has proposed that a trough plasma concentration of 10mg/l (when measured by high performance liquid chromatography) should be maintained for most infections, and that higher concentrations of 15 to 30mg/l for endocarditis, septic arthritis and osteomyelitis should be considered for severe infections.
Indehaveren af markedsføringstilladelsen har ikke udført specifikke undersøgelser til underbygning af denne indikation.
No specific study has been conducted by the MAH in support of this indication.
Resultaterne ved profylaktisk anvendelse ved tandkirurgiske indgreb tyder på, at teicoplanin kan være nyttigt.
Regarding dental surgery prophylaxis, the results suggested that teicoplanin could be useful.
Indehaveren af markedsføringstilladelsen har rettet teksten ind efter de centrale sikkerhedsoplysninger (CSP) og efter CHMP's retningslinjer for vurdering af lægemiddelforårsaget risiko for reproduktion og laktation hos mennesker: “From Data to labelling” (EMEA/CHMP/203927/2005).
Section 4.6 - Fertility, pregnancy and lactation The MAH has aligned the text so that it is in line with the CSP and the CHMP Guideline on risk assessment of medicinal products on human reproduction and lactation: From Data to labelling (EMEA/CHMP/203927/2005).
I punkt 4.4 og 4.8 af produktresuméet er der indsat en advarsel om, at patienterne bør overvåges særligt ved anvendelse af den højere dosering på 12 mg/kg to gange dagligt.
A warning has been included in sections 4.4 and 4.8 of the SmPC that patients should be especially monitored for adverse reactions when the higher dosage of 12mg/kg bid is administered.
Teicoplanin styrkebestemmes i henhold til Ph. Eur.-monografien om mikrobiologisk assay af antibiotika.
monograph for microbiological assay of antibiotics.
• Infektioner i hud og underliggende væv SSTI)
• Skin and soft tissue infections (SSTI)
med 10 mg/kg hver 12. time med 1-5 doser doser (initialdosering), derefter 6-10 mg/kg én gang dagligt, er effektivt til behandling af børn med grampositive infektioner såsom septikæmi, infektion i hud og underliggende væv og i knogler og led, nedre luftvejsinfektioner samt neutropeni og feber.
However the available data suggest that teicoplanin administered IV or IM at dosages of 10 mg/kg every 12 hours for 1 to 5 doses (loading dosage), then 6 to 10 mg/kg once daily, is effective in the treatment of Gram-positive infections such as septicaemia, skin and soft tissue infections, bone and joint infections, lower respiratory tract infections, and in neutropenia and fever, in children.
Vedligeholdelsesdoseringen på 6-12 mg/kg én gang dagligt, afhængigt af infektionens art, blev bibeholdt svarende til den nuværende praksis i nogle medlemsstater: 6 mg/kg én gang dagligt til komplicerede infektioner i hud og underliggende væv samt urinvejsinfektioner og pneumoni, og 12 mg/kg én gang dagligt til infektioner i knogler og led samt endokarditis.
As is the current practice in some member states, the maintenance dose of 6-12mg/kg od depending on the type of infection was maintained: 6mg/kg od for complicated skin, soft tissue and urinary tract infections and pneumonia and 12mg/kg od for bone and joint infections and endocarditis.
Alle vigtige sikkerhedsoplysninger, der er indeholdt i produktresuméet, er anført efter faldende vigtighed: Hypersensitivitetsreaktioner, infusionsrelaterede reaktioner (“red man syndrom”), svære bulløse reaktioner (herunder Stevens-Johnsons syndrom (SJS) og toksisk epidermal nekrolyse (TEN)), en advarsel om mulige bivirkninger ved anvendelse af den højere initialdosis på 12 mg/kg to gange dagligt (24 mg/kg/dag), trombocytopeni, nefrotoksicitet, ototoksicitet og superinfektion.
All the important safety information that has been included in the SmPC has been listed in order of importance: hypersensitivity reactions, infusion related reactions (Red Man Syndrome), severe bullous reactions (including Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN)), warning concerning the possible adverse reactions with the higher loading dose of 12mg/kg bid
Da den indledende dosering på 12 mg/kg to gange dagligt (24 mg/kg/dag) ikke er veletableret, er der i produktresuméets punkt 4.8 indsat en erklæring om, at patienterne bør overvåges særligt for bivirkninger ved den højere dosering på 12 mg/kg to gange dagligt (24 mg/kg/dag).
Since this loading dose of 12mg/kg bid (24mg/kg/day) is not well established, a clear statement in section 4.8 has been included in the SmPC that patients should be especially monitored for adverse reactions when higher dosages of 12mg/kg bid (24mg/kg/day) are administered.
Ved nedsat nyrefunktion angives behovet for dosisjustering fra fjerde behandlingsdag med teicoplanin.
Adults and elderly patients with impaired renal function The requirement for the adjustment of the dosage in patients with renal impairment, from the fourth day of treatment with teicoplanin has been included.
Også muligheden for lægemiddelreaktioner som følge af den højere initialdosering (som der gives mulighed for i punkt 4.2) er taget op af indehaveren af markedsføringstilladelsen.
The effect of the higher loading dose (as proposed in section 4.2) on the possible occurrence of adverse drug reactions has also been addressed by the MAH.
Det antibakterielle spektrum er blevet opdateret i overensstemmelse med CHMP's retningslinjer for vurdering af lægemidler til behandling af bakterielle infektioner (“Guideline on the Evaluation of Medicinal Products Indicated for the Treatment of Bacterial Infections” (CPMP/EWP/588/95 rev 2)).
The antibacterial spectrum has been updated in accordance with the CHMP Note for Guidance on Evaluation of Medicinal Products Indicated for Treatment of Bacterial Infections (CHMP/EWP/588/95 rev 2).
Indehaveren af markedsføringstilladelsen har desuden imødekommet CHMP's anmodning om at forelægge en risikostyringsplan (som indeholder PASS-protokollen), navnlig med tilstrækkeligt henblik på den vigtige potentielle risiko for øget forekomst af nefrotoksicitet og andre alvorlige bivirkninger ved en initialdosering på 12 mg/kg to gange dagligt (24 mg/kg/dag).
The MAH has also agreed to the request made by the CHMP to submit a risk management plan (in which the PASS protocol will be included), in particular, to adequately address the important potential risk of the increased frequency of nephrotoxicity and other serious adverse reactions with loading doses of 12mg/kg bid (24mg/kg/day).
I stedet er angivet indikationen bakteriæmi i overensstemmelse med CHMP's retningslinjer for vurdering af lægemidler til behandling af bakterielle infektioner (“Guideline on the Evaluation of Medicinal Products Indicated for the Treatment of Bacterial Infections” (CPMP/EWP/558/95 rev 2”).
Instead, the indication for bacteraemia has been included in accordance with CHMP Guideline on the Evaluation of Medicinal Products Indicated for the Treatment of Bacterial Infections (CPMP/EWP/558/95 rev 2).
CHMP har anmodet indehaveren af markedsføringstilladelsen om at forelægge en risikostyringsplan, der tilstrækkeligt imødegår de vigtige potentielle risici, navnlig den øgede forekomst af nefrotoksicitet og andre alvorlige bivirkninger ved en initialdosering på 12 mg/kg to gange dagligt (24 mg/kg/dag).
The CHMP has requested the MAH to submit a RMP within 6 months of the Commission Decision to adequately address the important potential risks, in particular, the increased frequency of nephrotoxicity and other serious reactions with loading doses of 12mg/kg bid (24mg/kg/day).
• udvalget godtog den harmonisering af produktresuméet, etiketteringen og indlægssedlen, der er foreslået af indehaveren af markedsføringstilladelsen, anbefalede CHMP ændring af betingelserne for de markedsføringstilladelser, for hvilke produktresumé, etikettering og indlægsseddel fremgår af bilag III for Targocid og relaterede navne (se bilag I).
the CHMP has recommended the variation to the terms of the marketing authorisations for which the summary of product characteristics, labelling and package leaflet are set out in Annex III for Targocid and associated names (see Annex I).
I det kliniske udviklingsprogram for teicoplanin blev der udført tre åbne, ikke kontrollerede undersøgelser med i.v.-formuleringen af teicoplanin, der blev administreret oralt mod antibiotikaassocieret diarré (AAD) og pseudomembranøs colitis (PMC) forårsaget af C. difficile.
Treatment of Clostridium difficile infection-associated diarrhoea and colitis In the clinical development program of teicoplanin, three open, non-controlled studies were conducted with teicoplanin IV formulation administered orally for antibiotic-associated diarrhea (AAD) and 1 Wiggins KJ, Cochrane Collaboration review and meta-analysis 2008.
Reed MD, Yamashita TS, Myers CM, et al. The pharmacokinetics of teicoplanin in infants and children.
4 Reed MD, Yamashita TS, Myers CM, et al.
• udvalget gennemgik markedsføringstilladelsesindehaverens dokumentation for den foreslåede harmonisering af produktinformation i form af data fra eksisterende kliniske undersøgelser, lægemiddelovervågningsdata og den publicerede litteratur,
• The Committee reviewed the available data on submitted by the MAH from the existing clinical studies, the pharmacovigilance data and the published literature justifying the proposed harmonisation of the SmPC.