Dinh Aurélien, Béraud Guillaume, Courjon Johan, Le Goff Yann, Ettahar Nicolas Kader, Grégoire Matthieu, Senneville Eric
Service des Maladies Infectieuses et Tropicales, Hôpital Raymond-Poincaré, 92380 Garches, France.
Service de Maladies Infectieuses, CHU d'Orléans, 45100 Orléans la Source, France.
Antibiotics (Basel). 2024 Jul 12;13(7):644. doi: 10.3390/antibiotics13070644.
To identify the current practices with long half-life lipoglycopeptides (LGPs) and potential use/position of oritavancin.
Despite their indication being limited to skin and soft tissue infections (SSTIs), long half-life lipoglycopeptides are mainly used off-label to treat bone and joint infections (BJIs) and infective endocarditis. Oritavancin and dalbavancin are both semisynthetic lipoglycopeptide antibiotics with activity against Gram-positive organisms. The game-changing property of these two antibiotics is their one-time dosing. Due to its shorter half-life, oritavancin might have an advantage over dalbavancin for a treatment duration of less than 2 weeks, as it could be used both in prolonged treatments of complicated patients in BJIs or administered as a single-dose treatment for Gram-positive cocci infections usually treated by a 5- to 10-day antibiotic course. These infections include urinary tract infections, bacteremias, catheter-related infections, etc. In addition to the possibility of being used as an end-of-treatment injection, oritavancin could be used as an empiric therapy treatment in the postoperative period in the context of device-associated especially prosthetic joint infections to allow for the early discharge of the patient.
A qualitative survey was conducted in March 2022 including sixteen infectiologists, one internist, five hospital pharmacists, and one pharmacologist.
Long half-life lipoglycopeptides contribute to changing the paradigm in the management of acute bacterial infections, as infectiologists now consider a range of indications and patient profiles for one single drug. Oritavancin strengthens the therapeutic arsenal in numerous infections from BJIs to urinary tract infections and could help to manage specific clinical situations, on top of providing potential benefits for the hospital's budget.
确定长效脂糖肽（LGP）的当前使用情况以及奥利万星的潜在用途/地位。
尽管长效脂糖肽的适应证仅限于皮肤和软组织感染（SSTI），但主要用于超适应证治疗骨和关节感染（BJI）及感染性心内膜炎。奥利万星和达巴万星均为半合成脂糖肽类抗生素，对革兰氏阳性菌有活性。这两种抗生素的突破性特性是其一次性给药。由于半衰期较短，对于治疗时间少于2周的情况，奥利万星可能比达巴万星更具优势，因为它可用于BJI复杂患者的延长治疗，或作为通常采用5至10天抗生素疗程治疗的革兰氏阳性球菌感染的单剂量治疗药物。这些感染包括尿路感染、菌血症、导管相关感染等。除了有可能用作治疗结束时的注射药物外，奥利万星还可在与器械相关尤其是人工关节感染的术后用作经验性治疗，以便患者早日出院。
2022年3月进行了一项定性调查，包括16名感染病专家、1名内科医生、5名医院药剂师和1名药理学家。
长效脂糖肽有助于改变急性细菌感染的管理模式，因为感染病专家现在会考虑单一药物的一系列适应证和患者情况。奥利万星增强了从BJI到尿路感染等多种感染的治疗手段，除了为医院预算提供潜在益处外，还可帮助处理特定临床情况。
