telavancin (Vibativ)
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Indications
- treatment of adult patients with complicated skin infections & skin structure bacterial infections caused by aerobic gram positive bacteria, including MRSA
- Staphylococcal nosocomial pneumonia
Contraindications
- caution in patients with renal insufficiency
- use alternative antibiotic when adverse reaction to vancomycin
- hypersensitivity cross-reactivity with vancomycin is unknown
Dosage
Injection: 250 & 750 mg vials for reconstitution; after reconstitution to a concentration of 15 mg/mL, it must be further diluted to a concentration of 0.6-8 mg/mL before administration
Pharmacokinetics
- longer 1/2 life than vancomycin
Monitor
- renal function
- prior to treatment
- at least every 72 hours during treatment
- at the end of therapy
Antimicrobial activity
- gram positive aerobic bacteria, including MRSA
- has lower minimal inhibitory activity to S aureus than vancomycin[3]
- Staphylococcus aureus (including MRSA)
- Streptococcus
Adverse effects
- taste disturbance, nausea, vomiting, & foamy urine are the most common side effects
- may cause increases in serum creatinine (nephrotoxicity)[3]
- may cause QT interval prolongation
Drug interactions
- telavancin does not appear to induce or inhibit cyt P450 to a clinically relevant extent
- possibly other drugs that prolong the QT interval (itraconazole, ondansetron, etc)
- possibly other affect kidney function (NSAIDs, ACE inhibitors, etc)
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
Test interactions
- telavancin can cause a false increase in coagulation tests
- does not affect actual coagulation
- telavancin binds to a reagent used in anticoagulation tests
Mechanism of action
- vancomycin analogue
More general terms
References
- ↑ Prescriber's Letter 16(11): 2009 New Drug: Vibativ (Telavancin) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251117&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Leonard SN, Rybak MJ. Telavancin: an antimicrobial with a multifunctional mechanism of action for the treatment of serious gram-positive infections. Pharmacotherapy. 2008 Apr;28(4):458-68. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18363530
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015
- ↑ Deprecated Reference
- ↑ Damodaran SE, Madhan S. Telavancin: A novel lipoglycopeptide antibiotic. J Pharmacol Pharmacother. 2011 Apr;2(2):135-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21772784 Free PMC Article
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3081362
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=44147490
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=6918703
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9812715
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=6918702