OVERVIEW

PRODUCT INFORMATION

CHEMICAL FORMULAS AND STRUCTURES

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DRUG	CAS REGISTRY NO	MOLECULAR FORMULA	STRUCTURE
Dalbavancin	171500-79-1	C88-H100-Cl2-N10-O28
Oritavancin	171099-57-3	C80-H106-Cl2-N11-O27-P
Telavancin	372151-71-8	C80-H106-Cl2-N11-O27-P
Vancomycin	1404-90-6	C66-H75-C12-N9-O24

ANNOTATED BIBLIOGRAPHY

References updated: 12 November 2017

• Moseley RH. Vancomycin. Hepatotoxicity of antimicrobials and antifungal agents. In, Kaplowitz N, DeLeve LD, eds. Drug-induced Liver Disease. 3rd edition. Amsterdam: Elsevier, 2013, p. 469.

  (Expert review of antibiotic induced liver injury discusses vancomycin, but not the other glycopeptide antibiotics).
• MacDougall C, Chambers HF. Protein synthesis inhibitors and miscellaneous antibacterial agents. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 1521-47.

  (Textbook of pharmacology and therapeutics).
• Billeter M, Zervos MJ, Chen AY, Dalovisio JR, Kurukularatne C. Dalbavancin: a novel once-weekly lipoglycopeptide antibiotic. Clin Infect Dis 2008; 46: 577-83. [PubMed: 18199045]

  (Review of the mechanism of action, efficacy and safety of dalbavancin mentions that it has been used in more than 1000 patients and “there is no known evidence of renal or hepatic toxicity”).
• Stryjewski ME, Graham DR, Wilson SE, O'Riordan W, Young D, Lentnek A, Ross DP, et al.; Assessment of Telavancin in Complicated Skin and Skin-Structure Infections Study. Telavancin versus vancomycin for the treatment of complicated skin and skin-structure infections caused by gram-positive organisms. Clin Infect Dis 2008; 46: 1683-93. [PubMed: 18444791]

  (Among 1867 patients with severe bacterial skin or skin structure infections treated with telavancin or vancomycin, clinical cure rates were similar [88% vs 87%] and common side effects included taste disturbance [33% vs 7%], nausea [27% vs 15%], headache [14% vs 13%], foamy urine [13% vs 3%], renal dysfunction [3% vs 1%], ALT elevations above 3 times ULN [2% vs 4%] and increase in QTc [1.2% vs 0.6%]).
• Telavancin (Vibativ) for gram-positive skin infections. Med Lett Drugs Ther 2010; 52 (1329): 1-2. [PubMed: 20208468]

  (Concise summary of the mechanism of action, clinical efficacy, side effects and costs of telavancin shortly after its approval in the US, mentions common side effects of nausea, diarrhea, renal dysfunction and taste disturbance and rare side effects of renal failure [~3%] and prolongation of the QTc interval).
• Rubinstein E, Lalani T, Corey GR, Kanafani ZA, Nannini EC, Rocha MG, Rahav G, et al.; ATTAIN Study Group. Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis 2011; 52: 31-40. [PMC free article: PMC3060890] [PubMed: 21148517]

  (Among 1503 patients with severe hospital acquired pneumonia treated with telavancin [10 mg/kg/day] or vancomycin [1 g every 12 hours] for 7-21 days, cure rates were similar [59% vs 59.5%], creatinine elevations occurred in 16% vs 10% and ALT elevations above 3 times ULN in 6% vs 8%).
• Boucher HW, Wilcox M, Talbot GH, Puttagunta S, Das AF, Dunne MW. Once-weekly dalbavancin versus daily conventional therapy for skin infection. N Engl J Med 2014; 370: 2169-79. [PubMed: 24897082]

  (Among 1312 patients with acute skin and skin structure infections treated with dalbavancin [day 1 and 8] or vancomycin [days 1-3] with an option to receive oral linezolid [days 4-14], clinical response rates were similar [80% vs 80%] and common side effects included nausea, diarrhea and pruritus; ALT elevations occurred in 23% of both groups but were usually mild, being above 3 times ULN occurred in 1.4% vs 0.2% of patients).
• Two new drugs for skin and skin structure infections. Med Lett Drugs Ther 2014; 56 (1449): 73-5. [PubMed: 25118799]

  (Concise review of the mechanism of action, efficacy, safety and cost of dalbavancin therapy shortly after its approval in the US mentions side effects of nausea, diarrhea, headache and infusion reactions [“red man syndrome”]; no mention of ALT elevations or hepatotoxicity).
• Corey GR, Kabler H, Mehra P, Gupta S, Overcash JS, Porwal A, Giordano P, et al.; SOLO I Investigators. Single-dose oritavancin in the treatment of acute bacterial skin infections. N Engl J Med 2014 Jun 5; 370 (23): 2180-90. [PubMed: 24897083]

  (Among 954 patients with severe bacterial skin and skin structure infections treated with oritavancin [single 1200 mg dose] or vancomycin [twice daily for 7 to 10 days], clinical cure rates were similar [80% vs 80%] as were adverse event rates; abnormal liver tests occurred in 2.3% of oritavancin vs 1.0% of vancomycin treated subjects, but none developed clinically apparent liver injury with jaundice).
• Barriere SL. The ATTAIN trials: efficacy and safety of telavancin compared with vancomycin for the treatment of hospital-acquired and ventilator-associated bacterial pneumonia. Future Microbiol 2014; 9: 281-9. [PubMed: 24450506]

  (Among 1532 patients with severe hospital acquired pneumonia treated with telavancin vs vancomycin, cure rates were similar [58% vs 59%] but all-cause mortality was higher with telavancin [39% vs 30%], while side effect rates were similar; no mention of ALT elevations or hepatotoxicity).
• Oritavancin (Orbactiv) for skin and skin structure infections. Med Lett Drugs Ther 2015; 57 (1459): 3-5. [PubMed: 25555072]

  (Concise summary of the mechanism of action, clinical efficacy, safety and costs of oritavancin shortly after its approval in the US for severe skin infections, mentions common side effects of nausea [10%], headache [7%] and diarrhea [4%], and that it does not have the renal and disturbed taste side effects of telavancin).
• Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al.; United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. Gastroenterology 2015; 148: 1340-52.e7. [PMC free article: PMC4446235] [PubMed: 25754159]

  (Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, 3 cases were attributed to vancomycin, but none to the other glycopeptide antibiotics).
• Dunne MW, Puttagunta S, Giordano P, Krievins D, Zelasky M, Baldassarre J. A randomized clinical trial of single-dose versus weekly dalbavancin for treatment of acute bacterial skin and skin structure infection. Clin Infect Dis 2016; 62: 545-51. [PMC free article: PMC4741365] [PubMed: 26611777]

  (Among 698 patients with skin or skin structure bacterial infections treated with 1500 mg of dalbavancin as either a single or as two infusions one week apart, the clinical response rates were similar [81% vs 84%] and adverse events rates were the same [20% vs 20%]; no mention of ALT elevations or hepatotoxicity).
• Dunne MW, Talbot GH, Boucher HW, Wilcox M, Puttagunta S. Safety of dalbavancin in the treatment of skin and skin structure infections: a pooled analysis of randomized, comparative studies. Drug Saf 2016; 39: 147-57. [PMC free article: PMC4735234] [PubMed: 26715497]

  (Among 1778 patients with skin or skin structure bacterial infections treated with dalbavancin and 1224 who received comparator agents in phase 2 and 3 studies, common side effects of dalbavancin included nausea [5.5% vs 6.4%], headache [4.7% vs 4.8%], diarrhea [4.4% vs 5.9%], rash [2% vs 1.8%] and pruritus [1.8% vs 2.9%]; ALT abnormalities of any degree occurred in 24% vs 26% of subjects and were above 3 times ULN in 2.6% vs 2.6%; no patient developed clinically apparent liver injury with jaundice).
• Bassetti M, Righi E. Safety profiles of old and new antimicrobials for the treatment of MRSA infections. Expert Opin Drug Saf 2016; 15 (4): 467-81. [PubMed: 26764972]

  (Summary and overview of the safety of recently developed drugs for MRSA infections including telavancin, dalbavancin and oritavancin mentions transient ALT elevations during therapy, but no mention of clinically apparent hepatotoxicity).