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The role of telavancin in hospital-acquired pneumonia and ventilator-associated pneumonia. [Review]

MedStar author(s):

Citation: Clinical Infectious Diseases. 61 Suppl 2:S79-86, 2015 Sep 15.PMID: 26316561Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov't | ReviewSubject headings: *Aminoglycosides/tu [Therapeutic Use] | *Anti-Bacterial Agents/tu [Therapeutic Use] | *Cross Infection/dt [Drug Therapy] | *Pneumonia, Ventilator-Associated/dt [Drug Therapy] | *Staphylococcal Infections/dt [Drug Therapy] | Aminoglycosides/ae [Adverse Effects] | Aminoglycosides/pd [Pharmacology] | Aminoglycosides/pk [Pharmacokinetics] | Anti-Bacterial Agents/ae [Adverse Effects] | Anti-Bacterial Agents/pd [Pharmacology] | Anti-Bacterial Agents/pk [Pharmacokinetics] | Bacteremia/dt [Drug Therapy] | Bacteremia/mi [Microbiology] | Clinical Trials, Phase III as Topic | Cross Infection/mi [Microbiology] | Humans | Methicillin-Resistant Staphylococcus aureus/de [Drug Effects] | Microbial Sensitivity Tests | Pneumonia, Ventilator-Associated/mi [Microbiology] | Staphylococcal Infections/mi [Microbiology]Year: 2015 Local holdings: Available online from MWHC library: June 1997 - present, Available in print through MWHC library: 1999 - Winter 2007ISSN:

1058-4838

Name of journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaAbstract: Hospital-acquired pneumonia (HAP) due to gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of morbid conditions and death. Telavancin is a lipoglycopeptide antibiotic with potent in vitro activity against a range of gram-positive pathogens, including MRSA, methicillin-susceptible S. aureus, and Streptococcus species. In 2 phase 3 clinical trials, telavancin was noninferior to vancomycin in patients with HAP due to gram-positive pathogens. Clinically evaluable patients with S. aureus as the sole pathogen or S. aureus with a vancomycin minimum inhibitory concentration >1 micro g/mL, however, had higher cure rates with telavancin than with vancomycin. In patients with bacteremic HAP, telavancin resulted in clearance of blood cultures. It was associated with increased serum creatinine levels and higher mortality rates in patients with moderate to severe renal impairment at baseline; however, on subsequent analysis, the outcomes seemed to have been at least partially affected by the adequacy of empiric gram-negative antimicrobial therapy. Thus, clinicians need to consider the risk-benefit balance when choosing telavancin in patients with severe renal impairment at baseline. Overall, these data support the use of telavancin in the treatment of HAP due to S. aureus, including MRSA and strains with elevated vancomycin minimum inhibitory concentrations, but clinicians should always weigh the risks and benefits of various treatment options. Copyright © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].All authors: Sandrock CE, Shorr AFFiscal year: FY2016Digital Object Identifier:

http://dx.doi.org/10.1093/cid/civ535

Date added to catalog: 2016-07-15

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26316561	Available		26316561

Available online from MWHC library: June 1997 - present, Available in print through MWHC library: 1999 - Winter 2007

Hospital-acquired pneumonia (HAP) due to gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of morbid conditions and death. Telavancin is a lipoglycopeptide antibiotic with potent in vitro activity against a range of gram-positive pathogens, including MRSA, methicillin-susceptible S. aureus, and Streptococcus species. In 2 phase 3 clinical trials, telavancin was noninferior to vancomycin in patients with HAP due to gram-positive pathogens. Clinically evaluable patients with S. aureus as the sole pathogen or S. aureus with a vancomycin minimum inhibitory concentration >1 micro g/mL, however, had higher cure rates with telavancin than with vancomycin. In patients with bacteremic HAP, telavancin resulted in clearance of blood cultures. It was associated with increased serum creatinine levels and higher mortality rates in patients with moderate to severe renal impairment at baseline; however, on subsequent analysis, the outcomes seemed to have been at least partially affected by the adequacy of empiric gram-negative antimicrobial therapy. Thus, clinicians need to consider the risk-benefit balance when choosing telavancin in patients with severe renal impairment at baseline. Overall, these data support the use of telavancin in the treatment of HAP due to S. aureus, including MRSA and strains with elevated vancomycin minimum inhibitory concentrations, but clinicians should always weigh the risks and benefits of various treatment options. Copyright © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].

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