Telavancin--對抗革蘭陽性菌的vancomycin的衍生物

Telavancin為vancomycin衍生物，是一種合成的lipoglycopeptide抗生素，對MRSA及Streptococcus pneumoniae及streptococci等革蘭陽性菌100%有效；和daptomycin或quinupristin/dalfopristin (Synercid)的效果相似；對enterococci 的96.5%有效。但Telavancin的腎毒性比 vancomycin還要強；已經由美國FDA批准使用於complicated skin and skin structure infections (cSSSI)。

Diagn Microbiol Infect Dis.  2012; 72(1):113-7 (ISSN: 1879-0070)

Mendes RE ; Sader HS ; Farrell DJ ; Jones RN
JMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USA. rodrigo-mendes@jmilabs.com

This study updates the activity of telavancin against Gram-positive pathogens collected from USA hospitals (2007-2009). Telavancin (MIC(50/90), 0.12/0.25 ?g/mL) was active against coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus (100% susceptible), for which only daptomycin (MIC(50/90), 0.25/0.5 ?g/mL; 99% susceptible) and quinupristin/dalfopristin (MIC(50/90), ≤ 0.25-0.5/0.5 ?g/mL; 99% susceptible) exhibited similar activity. Telavancin (MIC(50/90), 0.25/0.5 ?g/mL) inhibited 96.5% of Enterococcus faecalis at the Food and Drug Administration breakpoint (MIC, ≤ 1 ?g/mL), where ampicillin (99.9% susceptible), daptomycin (99.9% susceptible), and linezolid (100% susceptible) also demonstrated high-level coverage. Telavancin inhibited, respectively, 100.0% and 91.7% of VanB-phenotype E. faecalis and E. faecium at ≤ 1 ?g/mL, whereas it was less active against VanA strains. Telavancin was uniformly active against Streptococcus pneumoniae and resistant subsets, and demonstrated good potency (MIC(90), 0.06-0.12 ?g/mL) against other streptococci, regardless of resistance to other drugs. This assessment reveals potent activity of telavancin against Gram-positive isolates collected from USA hospitals with no evidence of emergence of resistance.

PreMedline Identifier:22078909