title: Effect of telavancin (Vibativ) on routine coagulation test results.
abstract: Telavancin (Vibativ, Astellas Pharma US, Deerfield, IL) is a lipoglycopeptide antibiotic that has activity against gram-positive microorganisms, but also has the ability to bind to artificial phospholipids found in coagulation reagents. Normal pooled plasma was spiked with telavancin to obtain concentrations of 0, 12.5, 25, 50, 75, 100, 125, and 150 μg/mL of drug. Samples were tested using 3 different prothrombin time/international normalized ratio (INR) and activated partial thromboplastin time (aPTT) reagent systems, as well as for fibrinogen level, thrombin time, D-dimer level, dilute Russell viper venom time (DRVVT), protein C activity, and protein S activity. There was no effect of telavancin seen with non-phospholipid-dependent assays: fibrinogen level, thrombin time, and D-dimer testing. All INR and aPTT systems demonstrated concentration-dependent increases in clotting times, with Innovin (Siemens Healthcare Diagnostics, Deerfield, IL) INRs the most dramatic. False-positive DRVVT ratios started at 12.5 μg/mL of telavancin, with no effect on protein C or protein S levels until the telavancin level reached more than 100 μg/mL.
authors.affiliation: Medical Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gosselin
authors.forename: William
authors.initials: W
authors.lastname: Dager
authors.forename: Aaron
authors.initials: A
authors.lastname: Roberts
authors.forename: Leslie
authors.initials: L
authors.lastname: Freeman
authors.forename: Lisa
authors.initials: L
authors.lastname: Gandy
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gregg
authors.forename: Denis
authors.initials: D
authors.lastname: Dwyre
mesh_terms: D000617:Aminoglycosides / Q000009:adverse effects / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D004334:Drug Administration Schedule; D005338:Fibrin Fibrinogen Degradation Products / Q000187:drug effects; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D019934:International Normalized Ratio; D000077427:Lipoglycopeptides; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D011994:Recombinant Proteins / Q000187:drug effects / Q000627:therapeutic use; D013918:Thrombin Time; D013925:Thromboplastin / Q000187:drug effects / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D005338:Fibrin Fibrinogen Degradation Products; C082196:Innovin; D000077427:Lipoglycopeptides; D011994:Recombinant Proteins; C036309:fibrin fragment D; D005340:Fibrinogen; D013925:Thromboplastin; C487637:telavancin