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Oritavancin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
As with the other glycopeptides, oritavancin is active against both aerobic and anaerobic Gram-positive bacteria. However, because of its inability to cross the outer membrane, oritavancin possesses no activity against Gram-negative bacteria (Ward et al., 2006). A summary of the antimicrobial activity of oritavancin is shown in Table 46.1.
Antimicrobial prescribing for treatment of serious infections caused by Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in pediatrics: an expert review
Published in Expert Review of Anti-infective Therapy, 2021
Sean N. Avedissian, Nathanial J. Rhodes, Christopher L. Shaffer, Lan Tran, John S. Bradley, Jennifer Le
Dalbavancin, oritavancin, and telavancin are semi-synthetic glycopeptide antibiotics with Gram-positive coverage similar to that of vancomycin, exhibiting bactericidal activity against MRSA. Pediatric data remain quite limited with these agents. In vitro data using isolates causing skin and skin structure infections in children showed good activity for dalbavancin against S. aureus and MRSA [37]. Briefly, the study comprised of a total of 770 S. aureus isolates from children <18 years old and found dalbavancin had MIC50/90 values of 0.03/0.06 ug/mL against S. aureus (445 MSSA and 315 MRSA). Dalbavancin MICs were also found to be 8–32 fold lower than those of competitor agents. Several studies have evaluated the pharmacokinetics of dalbavancin in pediatric patients, demonstrating a prolonged half-life which allows for infrequent dosing: 12–15 mg/kg IV as a single dose on day 1 than 6–7.5 my/kg on day 8 [38,39]. There are Phase III pediatric clinical study underway (clinicaltrials.gov # NCT02814916) to assess the pharmacokinetics/pharmacodynamics of these agents in pediatric patients with MRSA and VRE. Oritavancin (NCT02134301) and telavancin (NCT02013141) are also under study in children.
Novel developments in the treatment of acute bacterial skin and skin structure infections
Published in Expert Opinion on Pharmacotherapy, 2019
Rupal K. Jaffa, Kelly E. Pillinger, Danya Roshdy, Jacqueline A. Isip, Timothy R. Pasquale
Oritavancin is another lipoglycopeptide used to treat ABSSSI with a single dose of 1200 mg IV given over three hours. Like dalbavancin, oritavancin provides excellent activity against most Gram-positive organisms and targets similar resistant Gram-positive organisms with expanded activity against VRSA and vanB-type VRE. It contains a lipophilic side chain that allows for better membrane anchoring, prolongation of elimination half-life (393 h) and expansion of activity against Gram-positive bacteria; oritavancin also exhibits a high degree of plasma protein binding and has a large volume of distribution [36]. No dose adjustments are needed in patients with impaired renal function as very minimal amounts of oritavancin are excreted in the urine, only 5% of oritavancin is recovered in the urine over two weeks. Hemodialysis does not efficiently remove oritavancin [37].
Acute bacterial skin and soft tissue infections: new drugs in ID armamentarium
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Raghavendra Tirupathi, Swetha Areti, Sohail A. Salim, Venkatraman Palabindala, Nageshwar Jonnalagadda
Oritavancin is also a lipoglycopeptide antibiotic. This antibiotic has multiple mechanisms of action including inhibiting peptidoglycan cell wall synthesis and disrupting the bacterial cell membrane, leading to cell death and hence has bactericidal activity. Oritavancin is active against common gram-positive pathogens including methicillin-resistant Staphylococcus aureus, MSSA and strep species. The drug is administered as a single intravenous dose of 1200 mg over 3 h in adult patients, and because of its terminal half-life of 393 h, repeat dosing is not required in the treatment of SSTIs. There is a very slow elimination from tissue sites, and no dosing adjustments are required for renal or hepatic insufficiency. Two clinical trials (SOLO 1 and 2) have demonstrated non-inferiority compared with vancomycin in the treatment of SSTIs [8,9]. Side effects are similar to vancomycin and include liver enzyme elevation occasionally.