Telavancin versus standard therapy for treatment of complicated skin and soft-tissue infections due to Gram-positive bacteria

被引:125
作者
Stryjewski, ME
O'Riordan, WD
Lau, WK
Pien, FD
Dunbar, LM
Vallee, M
Fowler, VG
Chu, VH
Spencer, E
Barriere, SL
Kitt, MM
Cabell, CH
Corey, GR
机构
[1] Duke Clin Res Inst, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Div Infect Dis, Durham, NC USA
[3] Duke Univ, Med Ctr, Div Cardiol, Durham, NC USA
[4] eStudySite, San Diego, CA USA
[5] Theravance Inc, San Francisco, CA USA
[6] Straub Clin & Hosp, Honolulu, HI USA
[7] Louisiana State Univ, Med Ctr, New Orleans, LA USA
基金
美国国家卫生研究院;
关键词
D O I
10.1086/429914
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Telavancin, a novel lipoglycopeptide, exerts concentration-dependent, rapid bactericidal activity on account of its multiple mechanisms of action. Telavancin is highly active against gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate, and vancomycin-resistant strains. Methods. We conducted a randomized, double-blind, controlled, phase-2 clinical trial. Patients >= 18 years of age with a diagnosis of complicated skin and soft-tissue infection caused by suspected or confirmed gram-positive organisms were randomized to receive either intravenously administered telavancin once daily or standard therapy ( antistaphylococcal penicillin 4 times daily or vancomycin twice daily). Results. For the study, 167 patients were randomized and received at least 1 dose of study medication. Success rates were similar in all analysis populations at the test-of-cure evaluation. Of patients with S. aureus infection at baseline (n = 102), 80% of the telavancin group were cured and 77% of the standard therapy group were cured. For patients with MRSA infection at baseline (n = 48), cure rates were 82% for the telavancin group and 69% for the standard therapy group. Microbiologic eradication in patients with MRSA infection was 84% for the telavancin group versus 74% for the standard therapy group. MIC90 values were lower for telavancin in all tested strains of S. aureus (<= 0.25 ug/mL) compared with the MIC90 values for vancomycin and oxacillin. Similar proportions of patients discontinued therapy for adverse events in both treatment groups (similar to 5%). Fewer serious adverse events were reported in the telavancin group ( 4 events) than were for the standard therapy group ( 9). Conclusion. Clinical and microbiological results of this study support the further development of telavancin, especially for treatment of infection due to MRSA.
引用
收藏
页码:1601 / 1607
页数:7
相关论文
共 20 条
[1]   Effects of a new antibacterial, telavancin, on cardiac repolarization (QTc interval duration) in healthy subjects [J].
Burriere, S ;
Genter, F ;
Spencer, E ;
Kitt, M ;
Hoelscher, D ;
Morganroth, J .
JOURNAL OF CLINICAL PHARMACOLOGY, 2004, 44 (07) :689-695
[2]  
*CDCP, 2003, MMWR-MORBID MORTAL W, V52, P793
[3]  
Centers for Disease Control and Prevention (CDC), 2001, MMWR Morb Mortal Wkly Rep, V50, P919
[4]  
Centers for Disease Control and Prevention (CDC), 2003, MMWR Morb Mortal Wkly Rep, V52, P88
[5]   The changing epidemiology of Staphylococcus aureus? [J].
Chambers, HF .
EMERGING INFECTIOUS DISEASES, 2001, 7 (02) :178-182
[6]   Community-acquired methicillin-resistant Staphylococcus aureus infections in France:: Emergence of a single clone that produces Panton-Valentine leukocidin [J].
Dufour, P ;
Gillet, Y ;
Bes, M ;
Lina, G ;
Vandenesch, F ;
Floret, D ;
Etienne, J ;
Richet, H .
CLINICAL INFECTIOUS DISEASES, 2002, 35 (07) :819-824
[7]   Pharmacodynamics of telavancin (TD-6424), a novel bactericidal agent, against gram-positive bacteria [J].
Hegde, SS ;
Reyes, N ;
Wiens, T ;
Vanasse, N ;
Skinner, R ;
McCullough, J ;
Kaniga, K ;
Pace, J ;
Thomas, R ;
Shaw, JP ;
Obedencio, G ;
Judice, JK .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2004, 48 (08) :3043-3050
[8]   Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk [J].
Herold, BC ;
Immergluck, LC ;
Maranan, MC ;
Lauderdale, DS ;
Gaskin, RE ;
Boyle-Vavra, S ;
Leitch, CD ;
Daum, RS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (08) :593-598
[9]   Telavancin, a multifunctional lipoglycopeptide, disrupts both cell wall synthesis and cell membrane integrity in methicillin-resistant Staphylococcus aureus [J].
Higgins, DL ;
Chang, R ;
Debabov, DV ;
Leung, J ;
Wu, T ;
Krause, KA ;
Sandvik, E ;
Hubbard, JM ;
Kaniga, K ;
Schmidt, DE ;
Gao, QF ;
Cass, RT ;
Karr, DE ;
Benton, BM ;
Humphrey, PP .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2005, 49 (03) :1127-1134
[10]  
Hunt C, 1999, JAMA-J AM MED ASSOC, V282, P1123