Liapikou Adamantia, Dimakou Katerina, Toumbis Michael
6 Respiratory Department, Sotiria Hospital, Mesogion 152, 11527, Athens
5 Respiratory Department, Sotiria Hospital, Athens, Greece.
Ther Adv Respir Dis. 2016 Aug;10(4):368-78. doi: 10.1177/1753465816651594. Epub 2016 Jun 23.
Telavancin (TLV) is a lipoglycopeptide derivative of vancomycin (VAN), which has activity against Gram-positive aerobic bacteria, and is especially effective against methicillin-resistant Staphylococcus aureus (MRSA) and Gram-positive bacteria resistant to VAN. Comparative clinical studies of TLV have demonstrated noninferiority compared with VAN in the treatment of hospital-acquired Gram-positive pneumonia, with high cure rates for TLV-treated patients with monomicrobial S. aureus infection, including isolates with reduced VAN susceptibility. The results based on the patients' clinical response were supported by supplemental post-hoc analyses of 28-day mortality. In Europe and the USA, TLV is approved as a useful alternative for patients with difficult-to-treat, hospital-acquired MRSA pneumonia when there are very few alternatives. The present article reviews TLV's pharmacological characteristics and clinical efficacy resulting from clinical trials giving a detailed picture of its properties and position in the management of hospital-acquired pneumonia.
替考拉宁(TLV)是万古霉素(VAN)的脂糖肽衍生物,对革兰氏阳性需氧菌具有活性,尤其对耐甲氧西林金黄色葡萄球菌(MRSA)和对VAN耐药的革兰氏阳性菌有效。替考拉宁的比较临床研究表明,在治疗医院获得性革兰氏阳性肺炎方面,与万古霉素相比非劣效,对于接受替考拉宁治疗的单微生物金黄色葡萄球菌感染患者,包括对VAN敏感性降低的分离株,治愈率较高。基于患者临床反应的结果得到了28天死亡率补充事后分析的支持。在欧洲和美国,当几乎没有其他替代方案时,替考拉宁被批准作为治疗难治性医院获得性MRSA肺炎患者的有用替代药物。本文综述了替考拉宁的药理学特性和临床试验的临床疗效,详细介绍了其在医院获得性肺炎管理中的特性和地位。