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Telavancin

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Telavancin, Vibativ

  • See Also
  1. Glycopeptide Antibiotic
  2. Vancomycin
  • Indications
  1. See Glycopeptide Antibiotic
  2. Complicated Skin Infections (including MRSA)
  3. Hospital acquired or Ventilator associated Staphylococcus aureusPneumonia
    1. Not considered a first-line agent (other agents are preferred)
  • Contraindications
  1. eGFR <50 ml/min
    1. Mortality increased in Hospital Acquired Pneumonia (including Ventilator associated) compared with Vancomycin
  2. Known QT Prolongation (e.g. congenital, Drug-Induced QTc Prolongation)
  3. Decompensated Heart Failure
  4. Severe Left Ventricular Hypertrophy
  5. Unfractionated Heparin use (caution with Warfarin use)
  • Mechanism
  1. See Glycopeptide Antibiotic
  • Dosing
  1. IV formulation must be infused within 4 hours when left at room Temperature
  2. Standard Dosing (eGFR>50 ml/min)
    1. Give 10 mg/kg IV infused over 1 hour once daily for 7 to 14 days in Skin Infections (up to 21 days in Pneumonia)
  3. Renal Dosing (eGFR<50 ml/min)
    1. Telavancin is NOT recommended when eGFR<50 ml/min (see adverse effects and contraindications)
    2. eGFR 30 to 50 ml/min: 7.5 mg/kg IV every 24 hours
    3. eGFR 10 to 29 ml/min: 10 mg/kg IV every 48 hours
  • Adverse Effects
  1. See Glycopeptide Antibiotic
  2. QT Prolongation
  3. Nephrotoxic
    1. Monitor Renal Function every 2 to 3 days
    2. Avoid in eGFR <50 ml/min
    3. Accumulation of cyclodextrin carrier in renal dysfunction
  • Safety
  1. Unknown safety in Lactation
  2. Teratogenic in animals
    1. Avoid in pregnancy (despite pregnancy category C)
  • Drug Interactions
  1. Drug-Induced QTc Prolongation
  2. Falsely elevates coagulation studies (e.g. PTT, INR, Activated Clotting Time) for up to 18 hours after last dose
  • Resources
  1. Telavancin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9fc67b76-9ba1-45ec-9749-ca3f3a6477d9
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Lacy (2000) Drug Information Handbook, Lexi-Comp
  3. (2014) Presc Lett 21(8): 43