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Evaluation of a capped dosing telavancin regimen compared to standard dosing at a large community teaching hospital. Antimicrob Agents Chemother 2021; 66:e0160321. [PMID: 34662182 DOI: 10.1128/aac.01603-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Telavancin, a lipoglycopeptide antibiotic, is traditionally dosed as 10 mg/kg based on total body weight, but is associated with toxicities that limit its use. This study supports the use of a capped dosing regimen of 750 mg in obese patients, which is associated with equal efficacy and fewer adverse effects compared to traditional dosing.
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Kebriaei R, Rice SA, Singh NB, Stamper KC, Nguyen L, Sheikh Z, Rybak MJ. Combinations of (lipo)glycopeptides with β-lactams against MRSA: susceptibility insights. J Antimicrob Chemother 2020; 75:2894-2901. [DOI: 10.1093/jac/dkaa237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/15/2020] [Accepted: 05/04/2020] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
Increasing application of vancomycin due to the high prevalence of MRSA infections has led to the emergence of vancomycin intermediate-resistant Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA). Consequently, the need for alternative therapies that target MRSA has become evident.
Objectives
To evaluate the synergy between (lipo)glycopeptides (LGP/GPs) (vancomycin, teicoplanin, telavancin, dalbavancin and oritavancin) and β-lactams (ceftaroline, cefepime, cefazolin and oxacillin) against MRSA, hVISA, VISA and daptomycin non-susceptible (DNS) phenotypes.
Methods
Twenty randomly selected clinical MRSA strains (i.e. 5 MRSA, 5 hVISA, 5 VISA and 5 DNS) were assessed versus LGP/GPs alone and LGP/GPs in combination with β-lactams for MICs. Although verification of antibiotic potency against bacterial strains is assessed by the microbroth dilution (MBD) MIC method recommended by the CLSI, some antibiotics need modified assay conditions in order to demonstrate their optimal activity.
Results
Addition of β-lactams reduced MIC values of LGP/GPs against all strains (up to 160-fold reduction). In general, LGPs (dalbavancin, oritavancin and telavancin) were more active (significant differences in MIC values, up to 8-fold) compared with vancomycin and teicoplanin. The majority of these combinations were bactericidal and superior to any single agent.
Conclusions
This report has examined the susceptibility patterns of LGP/GPs and their combination with β-lactams. Of interest, the impact of susceptibility tests (in terms of MIC plates and their surface area) on the synergistic activity in 24 h time–kill experiments was apparent for LGPs. Further clinical research is required to investigate synergy with LGP/GPs and β-lactams against these Staphylococcus strains.
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Affiliation(s)
- Razieh Kebriaei
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Seth A Rice
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Nivedita B Singh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Kyle C Stamper
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Logan Nguyen
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Zain Sheikh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Michael J Rybak
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
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Malin JJ, de Leeuw E. Therapeutic compounds targeting Lipid II for antibacterial purposes. Infect Drug Resist 2019; 12:2613-2625. [PMID: 31692545 PMCID: PMC6711568 DOI: 10.2147/idr.s215070] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/29/2019] [Indexed: 12/18/2022] Open
Abstract
Resistance against commonly used antibiotics has emerged in all bacterial pathogens. In fact, there is no antibiotic currently in clinical use against which resistance has not been reported. In particular, rapidly increasing urbanization in developing nations are sites of major concern. Additionally, the widespread practice by physicians to prescribe antibiotics in cases of viral infections puts selective pressure on antibiotics that still remain effective and it will only be a matter of time before resistance develops on a large scale. The biosynthesis pathway of the bacterial cell wall is well studied and a validated target for the development of antibacterial agents. Cell wall biosynthesis involves two major processes; 1) the biosynthesis of cell wall teichoic acids and 2) the biosynthesis of peptidoglycan. Key molecules in these pathways, including enzymes and precursor molecules are attractive targets for the development of novel antibacterial agents. In this review, we will focus on the major class of natural antibacterial compounds that target the peptidoglycan precursor molecule Lipid II; namely the glycopeptides, including the novel generation of lipoglycopeptides. We will discuss their mechanism-of-action and clinical applications. Further, we will briefly discuss additional peptides that target Lipid II such as the lantibiotic nisin and defensins. We will highlight recent developments and future perspectives.
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Affiliation(s)
- Jakob J Malin
- University of Cologne, Department I of Internal Medicine, Division of Infectious Diseases, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Erik de Leeuw
- Institute of Human Virology and Department of Molecular Biology & Biochemistry of the University of Maryland, Baltimore School of Medicine, Baltimore, MD 21201, USA
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Vimberg V, Gazak R, Szűcs Z, Borbás A, Herczegh P, Cavanagh JP, Zieglerova L, Závora J, Adámková V, Balikova Novotna G. Fluorescence assay to predict activity of the glycopeptide antibiotics. J Antibiot (Tokyo) 2018; 72:114-117. [DOI: 10.1038/s41429-018-0120-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/13/2018] [Accepted: 10/04/2018] [Indexed: 11/09/2022]
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Patel JH, Churchwell MD, Seroogy JD, Barriere SL, Grio M, Mueller BA. Telavancin and Hydroxy Propyl-β-Cyclodextrin Clearance during Continuous Renal Replacement Therapy: An in vitro Study. Int J Artif Organs 2018; 32:745-51. [DOI: 10.1177/039139880903201006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background/Aims Telavancin is a lipoglycopeptide antimicrobial agent which has been approved in Europe and has been recently FDA approved in the United States. Telavancin's parenteral solution contains hydroxy propyl-β-cyclodextrin (HP-β-CD) to enhance its solubility. The disposition of telavancin and HP-β-CD during continuous renal replacement therapies (CRRT) has not been previously reported. Methods The transmembrane clearances (CLtm) of telavancin and HP-β-CD during continuous hemofiltration and hemodialysis were assessed using an in vitro bovine blood model with AN69 and polysulfone hemodiafilters at varying ultrafiltrate and dialysate flow rates (1, 2, 3, & 6 l/hr). Results The mean telavancin sieving coefficient ranged from 0.25 to 0.31 during continuous hemofiltration. At all ultrafiltration rates, no differences were observed in telavancin CLtm between the two hemodiafilter types. For continuous hemodialysis, mean telavancin saturation coefficients ranged from 0.10 to 0.43 and CLtm tended to be higher for the polysulfone hemodiafilter than the AN69 hemodiafilter, especially at higher flow rates. Mean HP-β-CD sieving coefficients ranged from 0.63 to 1.03 and saturation coefficients from 0.63 to 1.38, resulting in a CLtm that was similar to ultrafiltrate and dialysate flow rates. Conclusion Telavancin CLtm is dependent on hemodiafilter type, dialysate and ultrafiltration rates. CRRT with high ultrafiltrate or dialysate rates may result in sufficient telavancin clearance to alter telavancin dosing. HP-β-CD clearance by continuous hemodialysis or continuous hemofiltration is substantial and may be sufficient to prevent HP-β-CD accumulation in subjects receiving CRRT. Pharmacokinetic studies conducted in patients receiving CRRT and telavancin are needed to confirm these in vitro findings.
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Affiliation(s)
- Jignesh H. Patel
- University of Kentucky College of Pharmacy, Department of Pharmaceutical Sciences, Lexington, Kentucky - USA
- Renal Replacement Therapy Kinetics Study Group
| | - Mariann D. Churchwell
- University of Toledo College of Pharmacy, Department of Pharmacy Practice, Toledo, Ohio - USA
- Renal Replacement Therapy Kinetics Study Group
| | - Julie D. Seroogy
- Bioanalytical Chemistry, PharmacoFore, Inc., San Carlos, California - USA
| | - Steven L. Barriere
- Clinical & Medical Affairs, Theravance, Inc., South San Francisco, CA - USA
| | - Maricor Grio
- Arnold Palmer Hospital for Children, Orlando, Florida - USA
- Renal Replacement Therapy Kinetics Study Group
| | - Bruce A. Mueller
- University of Michigan College of Pharmacy, Department of Clinical, Social & Administrative Sciences, Ann Arbor, Michigan - USA
- Renal Replacement Therapy Kinetics Study Group
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Matzneller P, Österreicher Z, Reiter B, Lackner E, Stimpfl T, Zeitlinger M. Tissue pharmacokinetics of telavancin in healthy volunteers: a microdialysis study. J Antimicrob Chemother 2016; 71:3179-3184. [DOI: 10.1093/jac/dkw269] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/13/2016] [Accepted: 06/02/2016] [Indexed: 01/23/2023] Open
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Henson KER, Levine MT, Wong EAH, Levine DP. Glycopeptide antibiotics: evolving resistance, pharmacology and adverse event profile. Expert Rev Anti Infect Ther 2015; 13:1265-78. [PMID: 26165756 DOI: 10.1586/14787210.2015.1068118] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The first glycopeptide antibiotic was vancomycin, isolated from the soil in the 1950s; since then, the class has expanded to include teicoplanin and the new semisynthetic glycopeptides dalbavancin, oritavancin and telavancin. They are bactericidal, active against most Gram-positive organisms, and in a concentration-dependent manner, inhibit cell wall synthesis. Resistance to vancomycin has emerged, especially among enterococci and Staphylococcus aureus through a variety of mechanisms. This emerging resistance to vancomycin makes proper dosing and monitoring of the area under the curve/MIC critically important. The chief adverse effect of vancomycin is nephrotoxicity, which is also intricately related to its dose. The efficacy of the semisynthetic glycopeptides has been demonstrated in skin and soft-tissue infections, but remains to be seen in serious methicillin-resistant Staphylococcus aureus infections.
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Affiliation(s)
- Karl Evans R Henson
- a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA
| | - Miriam T Levine
- a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA
| | - Eunice Ann H Wong
- a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA
| | - Donald P Levine
- a 1 Department of Medicine, Division of Infectious Diseases, Detroit Medical Center and Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.,b 2 Department of Medicine, Division of General Internal Medicine, Detroit Receiving Hospital and University Health Center, Detroit, MI, USA
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Lovering AL, Safadi SS, Strynadka NCJ. Structural perspective of peptidoglycan biosynthesis and assembly. Annu Rev Biochem 2012; 81:451-78. [PMID: 22663080 DOI: 10.1146/annurev-biochem-061809-112742] [Citation(s) in RCA: 232] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The peptidoglycan biosynthetic pathway is a critical process in the bacterial cell and is exploited as a target for the design of antibiotics. This pathway culminates in the production of the peptidoglycan layer, which is composed of polymerized glycan chains with cross-linked peptide substituents. This layer forms the major structural component of the protective barrier known as the cell wall. Disruption in the assembly of the peptidoglycan layer causes a weakened cell wall and subsequent bacterial lysis. With bacteria responsible for both properly functioning human health (probiotic strains) and potentially serious illness (pathogenic strains), a delicate balance is necessary during clinical intervention. Recent research has furthered our understanding of the precise molecular structures, mechanisms of action, and functional interactions involved in peptidoglycan biosynthesis. This research is helping guide our understanding of how to capitalize on peptidoglycan-based therapeutics and, at a more fundamental level, of the complex machinery that creates this critical barrier for bacterial survival.
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Affiliation(s)
- Andrew L Lovering
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
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Putnam SD, Sader HS, Moet GJ, Mendes RE, Jones RN. Worldwide summary of telavancin spectrum and potency against Gram-positive pathogens: 2007 to 2008 surveillance results. Diagn Microbiol Infect Dis 2010; 67:359-68. [DOI: 10.1016/j.diagmicrobio.2010.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 03/18/2010] [Indexed: 11/28/2022]
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Belavic JM. Vibativ another weapon in the fight against antibiotic resistance. Nurse Pract 2010; 35:7-9. [PMID: 20644442 DOI: 10.1097/01.npr.0000383951.56477.ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010; 23:616-87. [PMID: 20610826 PMCID: PMC2901661 DOI: 10.1128/cmr.00081-09] [Citation(s) in RCA: 1351] [Impact Index Per Article: 96.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.
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Affiliation(s)
- Michael Z David
- Department of Pediatrics and Department of Medicine, the University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
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Zhanel GG, Calic D, Schweizer F, Zelenitsky S, Adam H, Lagacé-Wiens PR, Rubinstein E, Gin AS, Hoban DJ, Karlowsky JA. New Lipoglycopeptides. Drugs 2010; 70:859-86. [DOI: 10.2165/11534440-000000000-00000] [Citation(s) in RCA: 234] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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