Lipoglycopeptides
TREATMENT
Telavancin (7.5-10 mg/kg q24-48h, based on CrCl) is a lipoglycopeptide antibiotic that is FDA- approved for treatment of HABP and VABP caused by S. aureus and for complicated skin/soft tissue infections.
Telavancin is broadly active against gram-positive bacteria, including MRSA, VISA, heteroresistant VISA, daptomycin- and linezolid-resistant S. aureus, streptococci, vancomycin-sensitive enterococci, and some gram-positive anaerobes. The agent is not active against gram-negative bacteria, vancomycin-resistant S. aureus, and VRE.SPECIAL CONSIDERATIONS
Adverse events include nausea, vomiting, metallic or soapy taste, foamy urine, and nephrotoxicity (which necessitates serial monitoring of serum creatinine). Prehydration with normal saline may mitigate the nephrotoxicity observed with the use of this drug. Telavancin can also cause a minor prolongation of the QTc interval. Women of childbearing potential require a negative serum pregnancy test prior to receiving telavancin because of teratogenic effects noted in animals.
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