Open Access
Subscription Access
Open Access
Subscription Access
Telavancin: a Promising Weapon against Antimicrobial Resistance
Subscribe/Renew Journal
Antimicrobial resistance threatens the clinical effectiveness of many current antimicrobials, while jeopardizing important advances being made against major infections. This has led the World Health Organisation (WHO) to adopt Antimicrobial resistance as its theme for World Health Day 2011. While rational prescribing practices will help decrease the problem of resistance, we must have reserve drugs in our hands to fight this ever-increasing menace.
Over the past few years, there has been an intensified focus on the emergence of methicillin-resistant Staphlococcus aureus (MRSA), including both community-acquired and hospital-acquired strains, against which vancomycin became the drug of choice. Increased frequency of staphylococcal and enterococcal resistance to vancomycin has prompted a search for newer anti-MRSA agents.
Telavancin, a semi-synthetic derivative of vancomycin, was approved in September 2009 by the FDA for the treatment of complicated skin and skin structure infections, (cSSSI), caused by susceptible gram-positive bacteria, especially methicillin-resistant S. aureus (MRSA). It is also being proposed for treatment of nosocomial pneumonia, with focus on MRSA infections.
Major advantage of telavancin over vancomycin is its therapeutic potential against vancomycin-resistant organisms, including vancomycin-resistant enterococci and vancomycin-resistant S. aureus (VRSA). Telavancin inhibits bacterial cell wall synthesis and is ten times more active than vancomycin in this respect. However, unlike vancomycin, which has a slow, primarily bacteriostatic action telavancin demonstrates rapidly bactericidal properties. It also disrupts bacterial cell membrane potential and increases permeability and outflow of essential ions. It shows considerable penetration into skin blister fluid, thus accounting for its use in cSSSIs. With predictable and linear pharmacokinetic profile and low level of resistance against it, telavancin is a welcome addition to the clinicians' armoury in the fight against antimicrobial resistance.
Keywords
- Boeser KD. Another anti-MRSA agent making its way to the market. Infectious Disease News 2009 Nov 1. Accessed October 5, 2010
- Leonard, SN, Vidaillac C, Rybak, MJ. Activity of Telavancin against Staphylococcus aureus Strains with Various Vancomycin Susceptibilities in an In Vitro Pharmacokinetic/ Pharmacodynamic Model with Simulated Endocardial Vegetations. Antimicrobial Agents and Chemotherapy 2009 July; 53(7):2928-33
- Guskey MT, Tsuji BT. A Comparative Review of the Lipoglycopeptides: Oritavancinm, Dalbavancin, and Telavancin. Pharmacotherapy. 2010;30(1):80-94
- Corey RG, Stryjewski../../Downloads/telavancin/nrd3051. html - a1 EM, Weyenberg W, Yasothan U, Kirkpatrick../../ Downloads/telavancin/nrd3051.html - a3 P. Fresh from the Pipeline: Telavancin. Nature Reviews Drug Discovery 2009 Dec; 8: 929-30
- Jariwala R.VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives. Telavancin (VibativTM). National Drug Monograph 2010 March; 1-12
- Higgins DL, Chang R, Debabov DV, Leung J, Wu T, Krause KM, Sandvik E, Hubbard JM, Kaniga K, Schmidt Jr. DE, Qiufeng G, Cass RT, Karr DE, Benton BM, Humphrey PP. Telavancin, a Multifunctional Lipoglycopeptide, Disrupts both Cell Wall Synthesis and Cell Membrane Integrity in Methicillin- Resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy 2005 March; 49(3):1127-34
- Zou Y, Brunzelle JS, Nair SK. Crystal Structures of Lipoglycopeptide Antibiotic Deacetylases: Implications for the Biosynthesis of A40926 and Teicoplanin. Chemistry & Biology 2008 June 23;15(6):533-545
- Attwood RJ, LaPLante KL. Telavancin: A novel lipoglycopeptide antimicrobial agent. American Journal of Health-System Pharmacy 2007; 64(22): 2335-48
- Stryjewski ME, Graham DR, Wilson SE, et al. Telavancin versus vancomycin for the treatment of complicated skin and skinstructure infections caused by gram-positive organisms. Clin Infect Dis 2008;46:1683–93
- Available from Accessed September 20, 2010 Accessed September 20, 2010
- Available from http://www.centerwatch.com/druginformation/ fda-approvals/drug-details.aspx?DrugID=1055 . Accessed September 22, 2010
- Theravance, Inc. Theravance submits U.S. NDA for telavancin for the treatment of hospital-acquired pneumonia. January 26, 2009. Accessed September 26, 2010
- United States National Library of Medicine, National Institutes of Health. Comparison of telavancin and vancomycin for hospital-acquired pneumonia due to methicillin-resistant Staphylococcus aureus (ATTAIN 1). 2007. Accessed October 14, 2010
- United States National Library of Medicine, National Institutes of Health. Comparison of telavancin and vancomycin for hospital-acquired pneumonia due to methicillin-resistant Staphylococcus aureus (ATTAIN 2). 2007. Accessed October 14, 2010
- Pfaller MA, Mendes RE, Sader HS, Jones RN. Telavancin activity against Gram-positive bacteria isolated from respiratory tract specimens of patients with nosocomial pneumonia. J. Antimicrob. Chemother. (2010); doi: 10.1093/ jac/dkq33). Accessed October 10, 2010.
- Available from http://www.nlm.nih.gov/medlineplus/ druginfo/meds/a610004.html.Accessed October 15, 2010
Abstract Views: 223
PDF Views: 0