Telavancin

General

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

Adult Dosing

  • 10 mg/kg IV q24hr

Pediatric Dosing

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[1]

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

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014