Oritavancin, a single-dose, complete regimen, for the treatment of acute bacterial skin and skin structure infections

Abstract

Oritavancin, a lipoglycopeptide antibiotic, recently received US FDA approval for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSI). Oritavancin, unlike other intravenous antibiotics that are currently available for the treatment of ABSSSI (e.g., vancomycin, daptomycin, telavancin, dalbavancin), offers the option of a single-dose complete regimen. The dosing schedule of oritavancin eliminates the need for an indwelling catheter and introduces the possibility of avoidance of a hospital admission; although, treatment in non-hospital settings has not been adequately evaluated in clinical trials. The availability of oritavancin adds another agent to our antibiotic armamentarium providing dosing flexibility and an alternative treatment option for treatment of ABSSSI caused by susceptible bacteria, including methicillin-resistant Staphylococcus aureus.

Keywords:

• acute bacterial skin and skin structure infections
• complicated skin and skin structure infections
• glycopeptides
• lipoglycopeptides
• oritavancin

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Key issues

• Skin and skin structure infections (SSSI) are common reasons for physicians’ office or emergency department visits and hospital admissions.

• Oritavancin is a lipoglycopeptide antibiotic with potent activity against staphylococci, streptococci and enterococci.

• It has been approved by the US FDA for the treatment of acute bacterial SSSI caused by susceptible bacteria including methicillin-resistant Staphylococcus aureus.

• Activity of oritavancin against strains of vancomycin intermediate S. aureus, vancomycin-resistant S. aureus, VanA and VanB strains of vancomycin-resistant enterococci has been demonstrated.

• Oritavancin has been submitted for approval in Europe for the treatment of complicated SSSI. The European Commission is expected to make a decision by the first half of 2015.

• Oritavancin has a terminal half-life of 245 h. The presence of a lipophilic side chain prolongs the half-life of oritavancin enabling oritavancin to be dosed infrequently. However, concerns exist if an adverse reaction develops due to its protracted clearance and lack of significant removal via hemodialysis.

• Oritavancin 1200 mg administered intravenously over 3 h as a single-dose, complete regimen has proven to be efficacious in two Phase III clinical trials for treatment of adult patients with acute bacterial SSSI.

• The novel oritavancin dosing regimen offers healthcare providers additional treatment flexibility and adds to the antibiotic armamentarium.