Bassetti Matteo, Mikulska Malgorzata, Righi Elda, Nicolini Laura, Viscoli Claudio
University of Genoa School of Medicine, S Martino Hospital, Clinica Malattie Infettive, Infectious Diseases Division, AOU San Martino, Genova, Italy.
Expert Opin Investig Drugs. 2009 Apr;18(4):521-9. doi: 10.1517/13543780902845630.
Serious infections caused by Gram-positive bacteria, particularly multi-drug resistant, are an important cause of morbidity and mortality in patients admitted to intensive care units. Thus, new antibiotics covering these pathogens are urgently needed.
To review characteristics of telavancin, a novel antibiotic intended to use for treating infections caused by difficult Gram-positive bacteria, such as Staphylococcus aureus, resistant to meticillin or vancomycin, multi-drug-resistant Streptococcus pneumoniae or glycopeptide-resistant enterococci.
The studies on microbiological activity, clinical efficacy and safety of telavancin were reviewed.
RESULTS/CONCLUSION: Telavancin is a lipoglycopeptide administered intravenously once-daily and excreted with urine. It proved to be microbiologically active against numerous Gram-positive pathogens including drug-resistant staphylococci, enterococci and pneumococci. Large randomized Phase II and III clinical trials on efficacy and safety of telavancin in treating complicated skin and skin structure infections reported telavancin to be non-inferior to standard treatment (mostly vancomycin). Preliminary data on telavancin in hospital-acquired pneumonia, including ventilator-associated pneumonia, documented that telavancin was efficacious for this indication. Overall incidence of adverse events was similar for telavancin and the comparator arms. Mild and transient disgeusia, nausea and vomiting resulted to be more frequent in telavancin group. Increase in creatinine values was also observed in telavancin arm.
革兰氏阳性菌引起的严重感染,尤其是多重耐药菌感染,是重症监护病房患者发病和死亡的重要原因。因此,迫切需要能覆盖这些病原体的新型抗生素。
综述特拉万星的特性,这是一种新型抗生素,旨在用于治疗由难辨革兰氏阳性菌引起的感染,如对甲氧西林或万古霉素耐药的金黄色葡萄球菌、多重耐药肺炎链球菌或糖肽类耐药肠球菌。
对特拉万星的微生物活性、临床疗效和安全性的研究进行综述。
结果/结论:特拉万星是一种脂糖肽类抗生素,每日静脉给药一次,经尿液排泄。它对多种革兰氏阳性病原体具有微生物活性,包括耐药葡萄球菌、肠球菌和肺炎球菌。关于特拉万星治疗复杂性皮肤及皮肤结构感染的疗效和安全性的大型随机II期和III期临床试验报告称,特拉万星不劣于标准治疗(大多为万古霉素)。关于特拉万星治疗医院获得性肺炎(包括呼吸机相关性肺炎)的初步数据表明,特拉万星对该适应症有效。特拉万星组和对照组的不良事件总发生率相似。特拉万星组味觉障碍、恶心和呕吐等轻度和短暂症状更为常见。特拉万星组还观察到肌酐值升高。