Telavancin

General

• Type: Glycopeptide antibiotic active against MRSA
• Dosage Forms: IV
• Common Trade Names: Vibativ

Adult Dosing

• 10 mg/kg IV q24hr

Special Populations

• Pregnancy Rating: C
• Lactation: Unknown
• Renal Dosing
  • CrCl 30-50 mL/minute: 7.5 mg/kg IV q24hr
  • CrCl 10-29 mL/minute: 10 mg/kg IV q48hr
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug
• Concomitant use of IV heparin

Adverse Reactions

Serious

• Renal impairment
• C. diff colitis
• Prolonged QT

Common

• Nausea/vomiting, diarrhea, taste disturbance
• Foamy urine
• Dizziness
• Rigors
• Pruritus, rash

Pharmacology

• Half-life: 8hr
• Metabolism:
• Excretion: Urine
• Mechanism of Action: Lipoglycopeptide antibiotic that is a synthetic derivative of vancomycin; inhibits bacterial cell wall synthesis by interfering with polymerization and cross-linking of peptidoglycan

Antibiotic Sensitivities

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	S
	Strep. Pneumoniae	S
	Viridans strep	X1
	Strep. anginosus gp	X1
	Enterococcus faecalis	S
	Enterococcus faecium	S
	MSSA	S
	MRSA	S
	CA-MRSA	S
	Staph. Epidermidis	S
	C. jeikeium	S
	L. monocytogenes	S
Gram Negatives	N. gonorrhoeae	R
	N. meningitidis	R
	Moraxella catarrhalis	X1
	H. influenzae	X1
	E. coli	R
	Klebsiella sp	R
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	X1
	Serratia marcescens	R
	Salmonella sp	R
	Shigella sp	R
	Proteus mirabilis	X1
	Proteus vulgaris	R
	Providencia sp.	X1
	Morganella sp.	X1
	Citrobacter freundii	X1
	Citrobacter diversus	X1
	Citrobacter sp.	X1
	Aeromonas sp	X1
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	X1
	Francisella tularensis	X1
	Brucella sp.	R
	Legionella sp.	X1
	Pasteurella multocida	X1
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	X1
	Mycoplasm pneumoniae	X1
	Rickettsia sp	R
	Mycobacterium avium	X1
Anaerobes	Actinomyces	S
	Bacteroides fragilis	R
	Prevotella melaninogenica	R
	Clostridium difficile	S
	Clostridium (not difficile)	S
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	S

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia