|Main uses||Skin and skin structure infections (SSSI), hospital acquired pneumonia|
|Side effects||Nausea, diarrhea, headache, trouble sleeping, foamy urine, kidney problems, red man syndrome, QT prolongation, Clostridioides difficile infection|
|Typical dose||10 mg/kg|
|Protein binding||90%, mostly to albumin|
|Elimination half-life||9 hours|
|Excretion||76% in urine, <1% in feces|
|Chemical and physical data|
|Molar mass||1755.65 g·mol−1|
|3D model (JSmol)|
Telavancin, sold under the brand name Vibativ among others, is an antibiotics used to treat skin and skin structure infections (SSSI) and hospital acquired pneumonia. This includes that due to MRSA. It is given by injection into a vein.
Common side effects include nausea, diarrhea, headache, trouble sleeping, and foamy urine. Other side effects include kidney problems, red man syndrome, QT prolongation, and Clostridioides difficile infection. Use during pregnancy may harm the baby. It is a semi-synthetic lipoglycopeptide derived from vancomycin. It works by stopping bacteria from forming a cell wall.
Telavancin was approved for medical use in the United States in 2009. While it was approved in Europe in 2011, this approval was subsequently withdrawn. In the United States the medication costs about 570 USD per day as of 2021.
The typical dose is 10 mg/kg once per day for one to three weeks.
Common side effects include nausea, vomiting, constipation, and headache.
Mechanism of action
Like vancomycin, telavancin inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of the peptidoglycan in the growing cell wall (see Pharmacology and chemistry of vancomycin). In addition, it disrupts bacterial membranes by depolarization.
On 19 October 2007, the US Food and Drug Administration (FDA) issued an approvable letter for telavancin. Its developer, Theravance, submitted a complete response to the letter, and the FDA has assigned a Prescription Drug User Fee Act (PDUFA) target date of 21 July 2008.
On 19 November 2008, an FDA antiinfective drug advisory committee concluded that they would recommend telavancin be approved by the FDA.
Theravance has also submitted telavancin to the FDA in a second indication, nosocomial pneumonia, sometimes referred to as hospital-acquired pneumonia, or HAP. On 30 November 2012, an FDA advisory panel endorsed approval of a once-daily formulation of telavancin for nosocomial pneumonia when other alternatives are not suitable. However, telavancin did not win the advisory committee's recommendation as first-line therapy for this indication. The committee indicated that the trial data did not prove "substantial evidence" of telavancin's safety and efficacy in hospital-acquired pneumonia, including ventilator-associated pneumonia caused by Gram-positive organisms Staphylococcus aureus and Streptococcus pneumoniae. On 21 June 2013 FDA gave approval for telavancin to treat patients with hospital-acquired pneumonia, but indicated it should be used only when alternative treatments are not suitable. FDA staff had indicated telavancin has a "substantially higher risk for death" for patients with kidney problems or diabetes compared to vancomycin.
On March 11 2013, Clinigen Group plc and Theravance, Inc. announced that they have entered into an exclusive commercialization agreement in the European Union (EU) and certain other countries located in Europe for telavancin for the treatment of nosocomial pneumonia (hospital-acquired), including ventilator-associated pneumonia, known or suspected to be caused by methicillin resistant Staphylococcus aureus (MRSA) when other alternatives are not suitable.
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