Oritavancin: An investigational lipoglycopeptide antibiotic

Karaoui, Lamis R.; El-Lababidi, Rania; Chahine, Elias B.

doi:10.2146/ajhp110572

Cited by 22 publications

(8 citation statements)

References 50 publications

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“…The spectrum of activity of ORI includes Streptococcus species, E. faecalis, E. faecium and Staphylococcus species (including S. aureus, both MSSA and MRSA), as well as Clostridium species. Due to the ability to bind to D-ala-D-lac (D-alanyl-D-lactate) stem terminus, ORI retains activity against VRE isolates (including vanA and vanB productor strains), heteroresistant vancomycin-intermediate S. aureus (hVISA), VISA and VRSA [42][43][44][45][46][47].Thus, as expected, this review identified studies where the most frequently treated pathogens were Staphylococci, Enterococci and Streptococci, including 121 MRSA, 2 VISA, 1 MRSE and 10 VR E. faecium. A clinical cure was observed in more than two thirds of cases (66.7%, 58/87); it exceeded 81% (22/27) for MRSA.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Efficacy of Multidose Oritavancin: A Systematic Review

Baiardi,

Cameran Caviglia,

Piras

et al. 2023

Antibiotics

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Oritavancin (ORI) is a semisynthetic lipoglycopeptide approved as a single 1200 mg dose intravenous infusion for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) caused by Gram-positive organisms in adults. The pharmacokinetic/pharmacodynamic (PK/PD) linear kinetic profile and long terminal half-life (~393 h) of ORI make it therapeutically attractive for the treatment of other Gram-positive infections for which prolonged therapy is needed. Multidose regimens are adopted in real-world clinical practice with promising results, but aggregated efficacy data are still lacking. A comprehensive search on PubMed/Medline, Scopus, Cochrane and Google Scholar databases was performed to include papers published up to the end of January 2023. All articles on ORI multiple doses usage, including case reports, with quantitative data and relevant clinical information were included. Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality. Differences in opinion were adjudicated by a third party. From 1751 potentially relevant papers identified by this search, a total of 16 studies met the inclusion criteria and were processed further in the final data analysis. We extracted data concerning clinical response, bacteriologic response, mortality and adverse events (AEs). From the 16 included papers, 301 cases of treatment with multidose ORIs were identified. Multidose regimens comprised an initial ORI dose of 1200 mg followed by 1200 mg or 800 mg subsequent doses with a varying total number and frequency of reinfusions. The most often treated infections and isolates were osteomyelitis (148; 54.4%), ABSSSI (35; 12.9%) and cellulitis (14; 5.1%); and MRSA (121), MSSA (66), CoNS (17), E. faecalis (13) and E. faecium (12), respectively. Clinical cure and improvement by multidose ORI regimens were observed in 85% (231/272) and 8% (22/272) patients, respectively. Multidose ORI was safe and well tolerated; the most frequent AEs were infusion-related reactions and hypoglycemia. A multidose ORI regimen may be beneficial in treating other Gram-positive infections besides ABSSSIs, with a good safety profile. Further studies are warranted to ascertain the superiority of one multidose ORI scheme or posology over the other.

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Section: Discussionmentioning

confidence: 99%

The Clinical Efficacy of Multidose Oritavancin: A Systematic Review

Baiardi,

Cameran Caviglia,

Piras

et al. 2023

Antibiotics

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“…Dalbavancin and oritavancin have activity against VRE and S. aureus , including against MRSA and VISA [ 56 ]. While dalbavancin has no activity on VanA strains, oritavancin has activity on both VanA and VanB strains [ 57 , 59 , 60 ]. It also exhibits in vitro activity on S. aureus biofilms [ 56 ].…”

Section: Alternatives To Vancomycinmentioning

confidence: 99%

“…It also exhibits in vitro activity on S. aureus biofilms [ 56 ]. The advantage of oritavancin over the other two molecules is that it has three distinct MoAs, namely, depolarization of the membrane, inhibition of transglycosylation, and inhibition of transpeptidation, which limits the emergence of resistance ( Figure 1 ) [ 59 ]. Resistance has been demonstrated in the laboratory but not in the clinic [ 56 , 58 ].…”

Section: Alternatives To Vancomycinmentioning

confidence: 99%

Alternatives to Fight Vancomycin-Resistant Staphylococci and Enterococci

et al. 2021

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Gram positive pathogens are a significant cause of healthcare-associated infections, with Staphylococci and Enterococci being the most prevalent ones. Vancomycin, a last resort glycopeptide, is used to fight these bacteria but the emergence of resistance against this drug leaves some patients with few therapeutic options. To counter this issue, new generations of antibiotics have been developed but resistance has already been reported. In this article, we review the strategies in place or in development to counter vancomycin-resistant pathogens. First, an overview of traditional antimicrobials already on the market or in the preclinical or clinical pipeline used individually or in combination is summarized. The second part focuses on the non-traditional antimicrobials, such as antimicrobial peptides, bacteriophages and nanoparticles. The conclusion is that there is hitherto no substitute equivalent to vancomycin. However, promising strategies based on drugs with multiple mechanisms of action and treatments based on bacteriophages possibly combined with conventional antibiotics are hoped to provide treatment options for vancomycin-resistant Gram-positive pathogens.

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“…Data from in vitro studies support oritavancin use in endocarditis and bacteremia, particularly as it has excellent intracellular bactericidal activity [30, 31]. …”

Section: Oritavancinmentioning

confidence: 99%

New agents approved for treatment of acute staphylococcal skin infections

Tatarkiewicz¹,

Staniszewska²,

Bujalska‐Zadrożny³

2016

aoms

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Vancomycin has been a predominant treatment for methicillin-resistant Staphylococcus aureus (MRSA) infections for decades. However, growing reservations about its efficacy led to an urgent need for new antibiotics effective against MRSA and other drug-resistant Staphylococcus aureus strains. This review covers three new anti-MRSA antibiotics that have been recently approved by the FDA: dalbavancin, oritavancin, and tedizolid. The mechanism of action, indications, antibacterial activity profile, microbial resistance, pharmacokinetics, clinical efficacy, adverse effects, interactions as well as available formulations and administration of each of these new antibiotics are described. Dalbavancin is a once-a-week, two-dose, long-acting intravenous bactericidal lipoglycopeptide antibiotic. Oritavancin, a lipoglycopeptide with bactericidal activity, was developed as a single-dose intravenous treatment for acute bacterial skin and skin-structure infections (ABSSSI), which offers simplifying treatment of infections. Tedizolid is an oxazolidinone-class bacteriostatic once-daily agent, available for intravenous as well as oral use. Increased ability to overcome bacterial resistance is the main therapeutic advantage of the novel agents over existing antibiotics.

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Oritavancin: An investigational lipoglycopeptide antibiotic

Abstract: Oritavancin is an investigational semisynthetic antibiotic classified as a second-generation lipoglycopeptide, with promising activity against multidrug-resistant gram-positive pathogens.

Cited by 22 publications

References 50 publications

The Clinical Efficacy of Multidose Oritavancin: A Systematic Review

The Clinical Efficacy of Multidose Oritavancin: A Systematic Review

Alternatives to Fight Vancomycin-Resistant Staphylococci and Enterococci

New agents approved for treatment of acute staphylococcal skin infections

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