Stewart Cassie L, Turner Michelle S, Frens Jeremy J, Snider Cynthia B, Smith Jordan R
Moses Cone Hospital, Cone Health, Greensboro, NC, USA.
Fred Wilson School of Pharmacy, High Point University, High Point, NC, USA.
Infect Dis Ther. 2017 Jun;6(2):277-289. doi: 10.1007/s40121-017-0156-z. Epub 2017 Apr 6.
Oritavancin is a novel lipoglycopeptide approved for acute bacterial skin and skin structure infections. The pharmacokinetic profile and convenient one-time dosing make oritavancin an enticing option for other serious Gram-positive infections requiring prolonged treatment courses. Unfortunately, data for using oritavancin in these populations are limited.
We report ten cases of oritavancin use for invasive Gram-positive infections in our health system, and provide a review of the currently available literature regarding oritavancin therapy for invasive infections.
Among the ten patients who received oritavancin, the most common infection was methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia (n = 5, 50%). Other indications for oritavancin use included methicillin-resistant S. aureus (MRSA) bursitis (n = 1, 10%), group B streptococcal bacteremia with native tricuspid valve infective endocarditis (n = 1, 10%), coagulase-negative staphylococcal bacteremia (n = 1, 10%), MSSA deep tissue infection (n = 1, 10%), and enterococcal bacteremia (n = 1, 10%). Oritavancin was well tolerated, and 7/10 (70%) patients were successfully treated.
Oritavancin is a potential option for patients with invasive Gram-positive infections. Further study is warranted.
奥利万星是一种新型脂糖肽类药物,已被批准用于治疗急性细菌性皮肤及皮肤结构感染。其药代动力学特征以及方便的一次性给药方式,使奥利万星成为治疗其他需要长期疗程的严重革兰氏阳性菌感染的诱人选择。不幸的是,关于在这些人群中使用奥利万星的数据有限。
我们报告了在我们医疗系统中使用奥利万星治疗侵袭性革兰氏阳性菌感染的10例病例,并对目前关于奥利万星治疗侵袭性感染的现有文献进行了综述。
在接受奥利万星治疗的10例患者中,最常见的感染是甲氧西林敏感金黄色葡萄球菌(MSSA)菌血症(n = 5,50%)。奥利万星使用的其他适应症包括耐甲氧西林金黄色葡萄球菌(MRSA)滑囊炎(n = 1,10%)、伴有天然三尖瓣感染性心内膜炎的B组链球菌菌血症(n = 1,10%)、凝固酶阴性葡萄球菌菌血症(n = 1,10%)、MSSA深部组织感染(n = 1,10%)和肠球菌菌血症(n = 1,10%)。奥利万星耐受性良好,7/10(70%)的患者得到成功治疗。
奥利万星是侵袭性革兰氏阳性菌感染患者的一种潜在选择。有必要进行进一步研究。