II. Indications
- See Glycopeptide Antibiotic
- Refractory Skin and Soft Tissue Infections with failure to respond to maximal oral antibiotic coverage
IV. Mechanism
- See Glycopeptide Antibiotic
- Decreases Bacterial cell wall synthesis
- Similar coverage and mechanism to Vancomycin
- Long-acting agents, with a single Parenteral dose covering entire antibiotic course
V. Dosing: Adults
- Give 1200 mg IV Infused over 3 hours for single dose
- Single dose may be sufficient for MRSA Cellulitis
- No dosing adjustment needed in moderate hepatic or renal dysfunction
VI. Disadvantages
- Expensive ($2500 to $9500 per single dose)
VII. Safety
- Pregnancy Category C
- Unknown Safety in Lactation
VIII. Adverse Effects
- See Glycopeptide Antibiotic
-
Hypersensitivity
- May cross react with other Glycopeptide Antibiotics (e.g. Vancomycin)
- Osteomyelitis
IX. Pharmacokinetics
- Excreted in stool
- Half-Life: 10 days
X. Drug Interactions
- Do NOT infuse with Normal Saline (incompatible)
- Use D5W when Flushing line
- Falsely elevates Coagulation Factors
- PTT (up to 120 hours after dose)
- INR (up to 12 hours after dose)
- Clotting time (up to 24 hours after dose)
- D-Dimer (up to 72 hours)
XI. Resources
XII. References
- (2014) Presc Lett 21(8): 43
- Hamilton (2020) Tarascon Pocket Pharmacopoeia