Systematic Review and Meta-Analysis of the Efficacy and Safety of Telavancin for Treatment of Infectious Disease: Are We Clearer?

Sarkar

Therapeutic Advances in Infection

et al. 2017

Telavancin extensively binds to serum albumin (~93%) and has a relatively small volume of distribution. Telavancin is not biotransformed by any cytochrome P 450 microsomal enzymes and excreted mainly in the urine. Though welltolerated, worrisome adverse effects, including renal dysfunction and QTc prolongation are of potential concern. Given its extensive binding to plasma proteins, long half-life, and a long post-antibiotic effect, it represents a promising addition to the therapeutic armamentarium in combating infections caused by resistant Gram-positive pathogens, namely, MRSA.

Section: Current Statusmentioning

confidence: 99%

Telavancin: a novel semisynthetic lipoglycopeptide agent to counter the challenge of resistant Gram-positive pathogens

Sarkar

Therapeutic Advances in Infection

et al. 2017

“…Another issue, as discussed in a recent meta‐analysis, is that the vancomycin dose was lower in the trials conducted from 2005 to 2007 than the dose currently used in practice. Current recommendations for treating MRSA pneumonia advise dosing vancomycin to maintain trough concentrations of 15–20 μg/ml; however, mean vancomycin trough concentrations were ≥10 μg/ml in only 66% of patients in the ATTAIN trials .…”

Section: Discussionmentioning

confidence: 99%

Time Course and Extent of Renal Function Changes in Patients Receiving Treatment for Staphylococcal Pneumonias: An Analysis Comparing Telavancin and Vancomycin from the ATTAIN Trials

Nogid

Lacy

Jacobs³

et al. 2018

Pharmacotherapy

Study ObjectiveTelavancin and vancomycin are both approved for treatment of hospital‐acquired and ventilator‐associated bacterial pneumonias caused by Staphylococcus aureus, and both agents can cause renal dysfunction. The objective of this study was to assess renal function changes by performing renal shift table analyses of telavancin‐ and vancomycin‐treated patients in phase III trials.DesignRetrospective, descriptive analysis of data from the safety population from the Assessment of Telavancin for Treatment of Hospital‐Acquired Pneumonia (ATTAIN) trials.PatientsA total of 1503 adults with hospital‐acquired or ventilator‐associated bacterial pneumonia primarily caused by gram‐positive pathogens and who received telavancin (n = 751) or vancomycin (n = 752).Measurements and Main ResultsDecline or improvement in creatinine clearance (CrCl) across seven defined categories (≤30, >30–40, >40–50, >50–60, >60–70, >70–80, and >80 ml/min) was classified as negative or positive shifts, respectively. The number of categories crossed (either positive or negative) determined the grade of shift (of a potential grades 1–6, with crossing from one category to the next adjacent category defined as a grade 1 shift) at specific time points compared with baseline: day 4, day 7, and end of therapy (EOT). Approximately 77%–91.6% of patients had either no change or improvement of CrCl across all time points for both treatments. Negative shifts were consistent for telavancin (day 4, 19.3%; day 7, 19.0%; EOT, 23.0%) but increased over time for vancomycin (day 4, 8.4%; day 7, 12.3%; EOT, 19.3%). A significantly lower proportion of patients receiving vancomycin showed renal function decline on day 4 and day 7. At EOT, negative shift rates were similar between treatments (treatment difference 3.6% [95% CI −0.7 to 7.9]). At day 7 and EOT, a higher percentage of vancomycin‐treated patients experienced high‐grade negative shifts relative to telavancin (day 7, vancomycin 2.8% vs telavancin 1.9%; EOT, vancomycin 4.7% vs telavancin 4.1%), though differences were not statistically significant.ConclusionUse of shift tables revealed differences in timing of renal function changes in patients receiving telavancin and vancomycin. Telavancin‐related declines in renal function were similar at day 4 and day 7, with a slight increase by EOT. This differed from vancomycin, which caused a steady increase in the percentage of patients with renal function decline over time. A significant difference in negative renal shifts between treatments occurred at day 4 and day 7 and favored vancomycin; however, the difference was minimal and not significant at EOT.

“…Однако из-за высокого риска нежелатель-ных побочных явлений и потенциальной нефроток-сичности препарата требуется осторожность при его клиническом использовании [9].…”

Section: препаратunclassified

“…Оритаванцин (Oritavancin) [62] Телаванцин (Telavancin) [9] Окончание табл. 1 могут взаимодействовать с липидом II и ингиби-ровать формирование клеточной стенки бактерии.…”

Section: гликолиподепсипептидыunclassified

Етіологічна Терапія Бактеріальних Пневмоній Сьогодні Та В Майбутньому 3. Антибактеріальні Препарати, Що Розробляються

Abaturov¹,

Kryuchko²

2021

Стрімке зростання антибіотикорезистентних бактеріальних штамів ставить на порядок денний необхідність розробки нових антибактеріальних засобів і перегляду рекомендацій етіологічного лікування бактеріальних інфекцій, у тому числі пневмоній. У даний час розробляються нові антибактеріальні препарати, що порушують біосинтез пептидоглікану, тейхоєвої і ліпотейхоєвої кислот, а також прикріплення факторів вірулентності до стінки бактерії. Нові молекули старих класів антибіотиків і представники нових класів антибіотиків, мішенями яких є ліпіди II і III, тейхоєва та ліпотейхоєва кислоти, аланін-рацемаза і сортаза A, в найближчому майбутньому стануть практичними інструментами в клінічній практиці. Цілі та механізми дії нових антибактеріальних сполук зумовлюють їх клінічну ефективність та перспективність у майбутніх стратегіях лікування інфекційних бактеріальних захворювань.