Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
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Efficacy and Safety of Telavancin in Clinical Trials: A Systematic Review and Meta-Analysis
by Konstantinos A. Polyzos, Michael N. Mavros, Konstantinos Z. Vardakas, Marinos C. Makris, Petros I. Rafailidis, Matthew E. Falagas
Introduction
The epidemiology and antibiotic resistance of Staphylococcus aureus have evolved, underscoring the need for novel antibiotics, particularly against methicillin-resistant S. aureus (MRSA). Telavancin is a bactericidal lipoglycopeptide with potent activity against Gram-positive pathogens.
Objective
To systematically review and synthesize the available evidence from randomized controlled trials (RCTs) evaluating telavancin in the treatment of patients with infections due to Gram-positive organisms with the methodology of meta-analysis.
Results
Six RCTs comparing telavancin with vancomycin were included; 4 (2229 patients) referred to complicated skin and soft tissue infections (cSSTIs) and 2 (1503 patients) to hospital-acquired pneumonia (HAP). Regarding cSSTIs, telavancin and vancomycin showed comparable efficacy in clinically evaluable patients (odds ratio [OR] = 1.10 [95% confidence intervals: 0.82?1.48]). Among patients with MRSA infection, telavancin showed higher eradication rates (OR = 1.71 [1.08?2.70]) and a trend towards better clinical response (OR = 1.55 [0.93?2.58]). Regarding HAP, telavancin was non-inferior to vancomycin in terms of clinical response in two Phase III RCTs; mortality rates for the pooled trials were comparable with telavancin (20%) and vancomycin (18.6%). Pooled data from cSSTIs and HAP studies on telavancin 10 mg/kg indicated higher rates of serum creatinine increases (OR = 2.22 [1.38?3.57]), serious adverse events (OR = 1.53 [1.05?2.24]), and adverse event-related withdrawals (OR = 1.49 [1.14?1.95]) among telavancin recipients.
Conclusion
Telavancin might be an alternative to vancomycin in cases of difficult-to-treat MRSA infections. The potent antistaphylococcal activity of telavancin should be weighted against the potential for nephrotoxicity.
-by Konstantinos A. Polyzos, Michael N. Mavros, Konstantinos Z. Vardakas, Marinos C. Makris, Petros I. Rafailidis, Matthew E. Falagas
Introduction
The epidemiology and antibiotic resistance of Staphylococcus aureus have evolved, underscoring the need for novel antibiotics, particularly against methicillin-resistant S. aureus (MRSA). Telavancin is a bactericidal lipoglycopeptide with potent activity against Gram-positive pathogens.
Objective
To systematically review and synthesize the available evidence from randomized controlled trials (RCTs) evaluating telavancin in the treatment of patients with infections due to Gram-positive organisms with the methodology of meta-analysis.
Results
Six RCTs comparing telavancin with vancomycin were included; 4 (2229 patients) referred to complicated skin and soft tissue infections (cSSTIs) and 2 (1503 patients) to hospital-acquired pneumonia (HAP). Regarding cSSTIs, telavancin and vancomycin showed comparable efficacy in clinically evaluable patients (odds ratio [OR] = 1.10 [95% confidence intervals: 0.82?1.48]). Among patients with MRSA infection, telavancin showed higher eradication rates (OR = 1.71 [1.08?2.70]) and a trend towards better clinical response (OR = 1.55 [0.93?2.58]). Regarding HAP, telavancin was non-inferior to vancomycin in terms of clinical response in two Phase III RCTs; mortality rates for the pooled trials were comparable with telavancin (20%) and vancomycin (18.6%). Pooled data from cSSTIs and HAP studies on telavancin 10 mg/kg indicated higher rates of serum creatinine increases (OR = 2.22 [1.38?3.57]), serious adverse events (OR = 1.53 [1.05?2.24]), and adverse event-related withdrawals (OR = 1.49 [1.14?1.95]) among telavancin recipients.
Conclusion
Telavancin might be an alternative to vancomycin in cases of difficult-to-treat MRSA infections. The potent antistaphylococcal activity of telavancin should be weighted against the potential for nephrotoxicity.
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