Oritavancin: A New Lipoglycopeptide Antibiotic in the Treatment of Gram-Positive Infections

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• 作者：Karrine D. Brade ; Jeffrey M. Rybak ; Michael J. Rybak
• 关键词：Acute bacterial skin and skin structure infection ; Lipoglycopeptide ; Oritavancin
• 刊名：Infectious Diseases and Therapy
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：5
• 期：1
• 页码：1-15
• 全文大小：1,228 KB
• 刊物主题：Internal Medicine; Infectious Diseases;
• 出版者：Springer Healthcare
• ISSN：2193-6382

文摘

Resistance among Gram-positive organisms has been steadily increasing over the last several years; however, the development of new antibiotics to treat infections caused from these organisms has fallen short of the emergent need. Specifically, resistance among Staphylococcus aureus and Enterococcus spp. to essential antibiotics is considered a major problem. Oritavancin is a semisynthetic lipoglycopeptide antibiotic that was recently approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). While structurally related to vancomycin, oritavancin also possesses unique mechanisms of action that greatly enhance its antimicrobial potency against multi-drug resistant pathogens including both VanA- and VanB-mediated vancomycin-resistant enterococci. Owing to the addition of the highly hydrophobic tail group, oritavancin possesses a prolonged half-life ranging from 200–300 h. Although oritavancin is only currently Food and Drug Administration approved for ABSSSI, this agent may eventually play a role in additional indications where new innovative therapy is needed including bacteremia and deep-seeded, Gram-positive infections such as infective endocarditis or osteomyelitis. This review will focus on oritavancin’s spectrum of activity, mechanisms of action and resistance, pharmacokinetic and pharmacodynamic properties, and the completed and ongoing clinical studies evaluating its use.