Telavancin

Semisynthetic lipoglycopeptide with concentration-dependent bactericidal activity against gram-positive organisms in vitro. The source reports a 1-6-hour post-antibiotic effect against S. aureus/other gram-positive organisms. Despite approximately 90% protein binding, serum/albumin has little effect on in-vitro activity against staphylococci, streptococci and vancomycin-susceptible enterococci.

It inhibits peptidoglycan polymerization/cross-linking and disrupts bacterial-membrane barrier function. Use for proven or strongly suspected susceptible infection, guided by cultures or local epidemiology. Obtain appropriate specimens; empiric treatment may precede results. Additional gram-negative coverage may be needed.

The original adult complicated-skin-infection indication lists S. aureus including MRSA, S. pyogenes, S. agalactiae, the S. anginosus group (anginosus, intermedius, constellatus), and vancomycin-susceptible E. faecalis.

Age 18 years or older, complicated skin/skin-structure infection: 10 mg/kg IV over 60 minutes every 24 hours for 7-14 days, with duration according to site/severity and clinical/bacteriological response.

Cockcroft-Gault CrCl in mL/min: above 50, 10 mg/kg every 24 hours; 30-50, 7.5 mg/kg every 24 hours; 10 to under 30, 10 mg/kg every 48 hours. Primarily renal elimination requires adjustment at or below 50.

Insufficient information for specific regimens below CrCl 10, including HD.