The role of telavancin in the treatment of MRSA infections in hospital

Abstract

Background: Serious infections caused by Gram-positive bacteria, particularly multi-drug resistant, are an important cause of morbidity and mortality in patients admitted to intensive care units. Thus, new antibiotics covering these pathogens are urgently needed. Objective: To review characteristics of telavancin, a novel antibiotic intended to use for treating infections caused by difficult Gram-positive bacteria, such as Staphylococcus aureus, resistant to meticillin or vancomycin, multi-drug-resistant Streptococcus pneumoniae or glycopeptide-resistant enterococci. Methods: The studies on microbiological activity, clinical efficacy and safety of telavancin were reviewed. Results/conclusion: Telavancin is a lipoglycopeptide administered intravenously once-daily and excreted with urine. It proved to be microbiologically active against numerous Gram-positive pathogens including drug-resistant staphylococci, enterococci and pneumococci. Large randomized Phase II and III clinical trials on efficacy and safety of telavancin in treating complicated skin and skin structure infections reported telavancin to be non-inferior to standard treatment (mostly vancomycin). Preliminary data on telavancin in hospital-acquired pneumonia, including ventilator-associated pneumonia, documented that telavancin was efficacious for this indication. Overall incidence of adverse events was similar for telavancin and the comparator arms. Mild and transient disgeusia, nausea and vomiting resulted to be more frequent in telavancin group. Increase in creatinine values was also observed in telavancin arm. © 2009 Informa UK Ltd. All rights reserved

New antibiotics for bad bugs: where are we?

“…MIC values (MIC 90 ) of tested strains between 0.25 and 1 mg/L have been reported in an over 4,500 isolates of methicillin-susceptible S. aureus (MSSA) and MRSA worldwide 11–17. In several studies, telavancin MICs for MRSA ranged from two to eight times lower than those observed for vancomycin, teicoplanin, and linezolid [ 83 ]. Similarly, coagulase-negative staphylococci (CoNS) exhibited MIC 90 values between 0.25 and 1 mg/L.…”

“…Similarly, coagulase-negative staphylococci (CoNS) exhibited MIC 90 values between 0.25 and 1 mg/L. Telavancin also proved to have an excellent activity against MRSA and CoNS with reduced susceptibility to glycopeptides, together with both vancomycin-susceptible and resistant enterococci [ 83 ]. The potent anti-staphylococcal activity of telavancin may lead to consider this lipoglycopeptide as an alternative to vancomycin in cases of difficult-to-treat MRSA infections [ 84 , 85 ].…”

New antimicrobial approaches to gram positive respiratory infections

“…Telavancin distributed into lung tissue with epithelial lining fluid concentrations of approximately two-to eightfold above the MIC 90 of S. aureus for 24 h. Post antibiotic effect of 4e6 h were [28].…”

Light and Shade of New Antibiotics

“…Large randomized Phase 2 and 3 clinical trials on the efficacy and safety of telavancin in treating complicated skin and skin structure infections reported that telavancin was non-inferior to standard treatment, mostly vancomycin [42].…”