title: Glycopeptide antibiotics: evolving resistance, pharmacology and adverse event profile.
abstract: The first glycopeptide antibiotic was vancomycin, isolated from the soil in the 1950s; since then, the class has expanded to include teicoplanin and the new semisynthetic glycopeptides dalbavancin, oritavancin and telavancin. They are bactericidal, active against most Gram-positive organisms, and in a concentration-dependent manner, inhibit cell wall synthesis. Resistance to vancomycin has emerged, especially among enterococci and Staphylococcus aureus through a variety of mechanisms. This emerging resistance to vancomycin makes proper dosing and monitoring of the area under the curve/MIC critically important. The chief adverse effect of vancomycin is nephrotoxicity, which is also intricately related to its dose. The efficacy of the semisynthetic glycopeptides has been demonstrated in skin and soft-tissue infections, but remains to be seen in serious methicillin-resistant Staphylococcus aureus infections.
authors.affiliation: a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.
authors.forename: Karl Evans R
authors.initials: KE
authors.lastname: Henson
authors.affiliation: a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.
authors.forename: Miriam T
authors.initials: MT
authors.lastname: Levine
authors.affiliation: a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.
authors.forename: Eunice Ann H
authors.initials: EA
authors.lastname: Wong
authors.affiliation: a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.|b 2 Department of Medicine, Division of General Internal Medicine, Detroit Receiving Hospital and University Health Center, Detroit, MI, USA.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Levine
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: adverse events; dalbavancin; glycopeptides; oritavancin; pharmacodynamics; pharmacokinetics; teicoplanin; telavancin; vancomycin