Oritavancin: a novel glycolipopeptide active against Gram-positive pathogens including multiresistant strains

Emilio Bouza (1) , Almudena Burillo (1)

1 Clinical Microbiology and Infectious Diseases Department

Oritavancin is a glycolipopeptide antibiotic under investigation for the treatment of serious infections caused by Gram-positive bacteria. Oritavancin has demonstrated rapid dose-dependent bactericidal activity towards vancomycin-susceptible and -resistant enterococci, meticillin-susceptible and -resistant , vancomycin-intermediate (VISA), heteroresistant VISA (hVISA), vancomycin-resistant (VRSA) and small-colony variants of . It is also active against . Upon intravenous administration, oritavancin displays a three-compartment pharmacokinetic model, dose proportionality, a distribution volume of ca. 110 L, a terminal elimination half-life in excess of 2 weeks and it is not metabolised. Its pharmacodynamic properties make it an ideal antibiotic for a once-daily or even single-dose regimen. Oritavancin is currently under review by the US Food and Drug Administration. So far, oritavancin has demonstrated efficacy in two pivotal Phase III trials conducted in patients with complicated skin and skin-structure infections in which oritavancin was compared with vancomycin plus cefalexin. In both trials, the primary endpoint (clinical cure in clinically evaluable patients at first follow-up with a 10% non-inferiority margin) was met, with the advantages of shorter duration of therapy and fewer adverse events. Further results indicating its activity against bacteria growing in biofilms as well as stationary-phase bacteria open the way for its use to treat prosthetic device infections, which is to be investigated in upcoming trials.

Mots clés: Oritavancin; Therapeutic use; Glycopeptides; Gram-positive bacterial infections; Vancomycin resistance

Emilio Bouza, Almudena Burillo. Oritavancin: a novel glycolipopeptide active against Gram-positive pathogens including multiresistant strains. International Journal of Antimicrobial Agents, 2010, 36 (5), pp.401. ⟨10.1016/j.ijantimicag.2010.06.048⟩. ⟨hal-00629945⟩