Telavancin
Mechanism :
Inhibits bacterial cell wall synthesis by blocking polymerization and cross-linking of peptidoglycan by binding to D-Ala-D-Ala portion of cell wall. Unlike vancomycin, additional mechanism involves disruption of membrane potential and changes cell permeability due to presence of lipophilic side chain moiety.
Indication :
- Treatment of complicated skin and skin structure infections caused by susceptible gram-positive organisms
- Hospital-acquired and ventilator-associated bacterial pneumonia caused by susceptible isolates of Staphylococcus aureus.
Contraindications :
Hypersensitivity to telavancin or any component of the formulation; concomitant use of intravenous unfractionated heparin.
Dosing :
Pediatric safety and efficacy not established.
Adults:
10 mg/kg administered over a 60-minute period IV once every 24 hours. Duration is 7 to 14 days for skin and soft tissue infections and 7-21 days for hospital acquired bacterial pneumonia due to S.aureus.
Adverse Effect :
Taste disturbance, nausea, vomiting, foamy urine, diarrhea, dizziness, rigors, pruritus, rash.
Interaction :
Heparin: Telavancin may diminish the therapeutic effect of Heparin. Specifically, telavancin may artificially increase the results of laboratory tests commonly used to monitor IV heparin effectiveness, which could lead to incorrect decisions to decrease heparin doses.
Hydroxychloroquine: May enhance the QTc-prolonging effect of QTc-Prolonging Agents.
Hepatic Dose :
No dose adjustment recommended.