Successful treatment of a prosthetic hip infection due to Enterococcus faecalis with sequential dosing of oritavancin and prosthesis preservation without prosthetic joint surgical manipulation

Nguyen, Jullian P.; Contreras, Brian X.; Sierra-Hoffman, Miguel; Saddler, Kim; Stevens, Mark L.; Castro-Lainez, Miriams T.; Knox, Brett; Deliz, Rafael J.

doi:10.1016/j.idcr.2020.e00949

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…According to our inclusion criteria, we selected 16 papers [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] for data extraction (see Supplementary Materials Table S1). They were all retrospective and most of them were case reports or case series (10/16; 62.5%).…”

Section: Resultsmentioning

confidence: 99%

“…S. aureus was the predominant pathogen with the highest success rate (81.5% MRSA, 75.0% MSSA), followed by CoNS (58.3%) and Enterococci. According to our inclusion criteria, we selected 16 papers [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] for data extraction (see Supplementary Materials Table S1). They were all retrospective and most of them were case reports or case series (10/16; 62.5%).…”

Section: Resultsmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Clinical Efficacy of Multidose Oritavancin: A Systematic Review

Baiardi,

Cameran Caviglia,

Piras

et al. 2023

Antibiotics

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“…Oritavancin has shown adequate in vitro bactericidal activity and sterilisation ability of biofilms, and some retrospective applications have described successful use in bone and prosthetic-associated infections as well [19,21,24,25], including one case with retained prosthetic materials [24]. In vitro studies have shown the ability of oritavancin to accumulate extensively in macrophages, potentially enhancing the eradication of pathogens that survive in lysosomes [1].…”

Section: Discussionmentioning

confidence: 99%

“…There are studies [18,19,21] and case reports [22][23][24][25] describing off-label use in bone and prosthetic-associated infections. A multicentre retrospective study described 134 patients with acute osteomyelitis who obtained clinical success in 88.1% of cases-defined as the resolution of symptoms or improvement of symptoms and no further need for treatment-after receiving four or five doses of oritavancin (1200 mg, then 800 mg weekly).…”

Section: Oritavancin In Bone and Prosthetic Joint Infectionsmentioning

confidence: 99%

“…Oritavancin also displays activity against Enterococcus spp. In addition, case reports of its sequential use in bone and prosthetic-associated infections have started to emerge as a simplification strategy after initial treatment with daptomycin plus ampicillin [24], or combined with ampicillin in the case of vanA-producing vancomycin-resistant Enterococcus faecium (VRE) device-associated vertebral osteomyelitis [24,25], even though the drug is approved only for vancomycin-susceptible Enterococcus faecalis. To date, no clinical trials have been registered on clinicaltrial.gov for oritavancin use in bone or prosthetic-associated joint infections.…”

Section: Oritavancin In Bone and Prosthetic Joint Infectionsmentioning

confidence: 99%

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Role of Oritavancin in the Treatment of Infective Endocarditis, Catheter- or Device-Related Infections, Bloodstream Infections, and Bone and Prosthetic Joint Infections in Humans: Narrative Review and Possible Developments

Lupia

Benedetto

Bosio

et al. 2023

Life

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Oritavancin is a long-acting lipoglycopeptide with in vitro activity against Gram-positive pathogens, as well as good bactericidal activity and sterilisation ability in biofilm. It has been approved for acute bacterial skin and skin structure infections (ABSSSI), but recent reports have demonstrated possible off-label uses, such as for vancomycin resistant enterococci (VRE), deep-seated infections including those involving prosthetic material and invasive infections. The aim of this work is to review the uses of oritavancin outside of ABSSSI, focusing on its real-life applications on infective endocarditis, catheter- or device-related infections, bloodstream infections, and bone and prosthetic joint infections in humans, as well as possible future applications. We performed a narrative review, collecting the literature published between 1 December 2002 and 1 November 2022 on PubMed and the Cochrane Library using the term ‘oritavancin’. Available studies have shown how effective it is in different settings, suggesting an opportunity for step-down strategies or outpatient management of infections requiring a long duration of antibiotic treatment. So far, evidence is still scarce, and limited to a few studies and case reports, mostly focusing on Staphylococcus aureus as the major isolate. Concerns about fluid intake for dilution and interaction with coagulation markers also need to be taken into account. Further studies are required in order to assess the safety and effectiveness of Oritavancin in vascular, prosthetic, or device-related infections, as well as in resistant Gram-positive bacteria or enterococcal infections.

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