title: Oritavancin: A Long-Half-Life Lipoglycopeptide.
abstract: Oritavancin is a lipoglycopeptide antibiotic that has been shown to be effective for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). This antibiotic has multiple mechanisms of action including inhibiting peptidoglycan cell wall synthesis and disrupting bacterial cell membrane, leading to cell death. Oritavancin is highly active against common gram-positive pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-intermediate S. aureus, vancomycin-resistant S. aureus, and vancomycin-resistant enterococci. The drug is administered as a single intravenous dose of 1200 mg over 3 hours in adult patients, and because of its terminal half-life of 393 hours, repeat dosing is not required in the treatment of ABSSIs. There is a very slow elimination from tissue sites, and no dosing adjustments are required for renal or hepatic insufficiency. Two clinical trials have demonstrated noninferiority compared with vancomycin in the treatment of ABSSSIs. Other than liver enzyme elevation and the occurrence of osteomyelitis, oritavancin has been associated with adverse events similar to those of vancomycin in follow-up for up to 60 days. Patients should be monitored for osteomyelitis and alternate therapy given in the case of confirmed or suspected osteomyelitis. Although oritavancin is an attractive antibiotic to consider in the outpatient area, its efficacy and safety in the treatment of other sites of infection are yet to be established.
authors.affiliation: St John Hospital and Medical Center, Grosse Pointe Woods Michigan State University, East Lansing.
authors.forename: Louis D
authors.initials: LD
authors.lastname: Saravolatz
authors.affiliation: St John Hospital and Medical Center, Grosse Pointe Woods Michigan State University, East Lansing.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Stein
mesh_terms: D061605:Administration, Intravenous; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D004798:Enzymes / Q000097:blood; D006020:Glycopeptides / Q000493:pharmacokinetics* / Q000494:pharmacology* / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006207:Half-Life; D006801:Humans; D000077427:Lipoglycopeptides; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D010019:Osteomyelitis / Q000139:chemically induced; D017192:Skin Diseases, Bacterial / Q000188:drug therapy; D018461:Soft Tissue Infections / Q000188:drug therapy; D014640:Vancomycin / Q000031:analogs & derivatives
chemical_list: D000900:Anti-Bacterial Agents; D004798:Enzymes; D006020:Glycopeptides; D000077427:Lipoglycopeptides; C100708:oritavancin; D014640:Vancomycin
keywords: MRSA; Staphylococcus aureus; antibacterial agents; oritavancin