Corey G Ralph, Rubinstein Ethan, Stryjewski Martin E, Bassetti Matteo, Barriere Steven L
Department of Medicine, Duke Clinical Research Institute, Durham, North Carolina.
Section of Infectious Diseases, Department of Internal Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Canada.
Clin Infect Dis. 2015 Mar 1;60(5):787-96. doi: 10.1093/cid/ciu971. Epub 2014 Dec 3.
Staphylococcus aureus bacteremia (SAB) is one of the most common serious bacterial infections and the most frequent invasive infection due to methicillin-resistant S. aureus (MRSA). Treatment is challenging, particularly for MRSA, because of limited treatment options. Telavancin is a bactericidal lipoglycopeptide antibiotic that is active against a range of clinically relevant gram-positive pathogens including MRSA. In experimental animal models of sepsis telavancin was shown to be more effective than vancomycin. In clinically evaluable patients enrolled in a pilot study of uncomplicated SAB, cure rates were 88% for telavancin and 89% for standard therapy. Among patients with infection due to only gram-positive pathogens enrolled in the 2 phase 3 studies of telavancin for treatment of hospital-acquired pneumonia, cure rates for those with bacteremic S. aureus pneumonia were 41% (9/22, telavancin) and 40% (10/25, vancomycin) with identical mortality rates. These data support further evaluation of telavancin in larger, prospective studies of SAB.
金黄色葡萄球菌血症（SAB）是最常见的严重细菌感染之一，也是耐甲氧西林金黄色葡萄球菌（MRSA）引起的最常见侵袭性感染。治疗具有挑战性，尤其是对于MRSA，因为治疗选择有限。替拉万星是一种杀菌性脂糖肽类抗生素，对包括MRSA在内的一系列临床相关革兰氏阳性病原体具有活性。在脓毒症的实验动物模型中，替拉万星被证明比万古霉素更有效。在一项关于非复杂性SAB的试点研究中纳入的临床可评估患者中，替拉万星的治愈率为88%，标准治疗的治愈率为89%。在两项替拉万星治疗医院获得性肺炎的3期研究中纳入的仅因革兰氏阳性病原体感染的患者中，血行性金黄色葡萄球菌肺炎患者的治愈率分别为41%（9/22，替拉万星）和40%（10/25，万古霉素），死亡率相同。这些数据支持在更大规模的SAB前瞻性研究中进一步评估替拉万星。
