Telavancin, a novel
lipoglycopeptide with rapid concentration-dependent bactericidal effects, is a semisynthetic derivative of the
glycopeptide,
vancomycin.
Telavancin has a dual mechanism of action, ie, inhibition of
peptidoglycan polymerization and disruption of the bacterial membrane. It has linear pharmacokinetics, rapid bactericidal killing, and broad spectrum activity against Gram positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and
vancomycin-resistant S. aureus. Phase II and III clinical trials for complicated skin and skin structure
infections have shown
telavancin to have similar efficacy and tolerability to that of
vancomycin and standard anti-staphylococcal β-
lactams plus
vancomycin. In Phase II trials, there was a significant difference in eradication of MRSA between groups, ie,
telavancin therapy 92% and standard
therapy (
vancomycin,
nafcillin,
oxacillin, or
cloxacillin) 68% (P < 0.05). In Phase III trials, among clinically evaluable patients who had MRSA isolated at baseline, the overall therapeutic response was higher in patients treated with
telavancin than in patients treated with
vancomycin (89.9% versus 84.7%; 95% CI -0.3, 10.5). Also, the efficacy of
telavancin was not inferior to that of
vancomycin for the treatment of complicated skin and skin structure
infections in the clinical trials.