II. Indications

  1. See Glycopeptide Antibiotic
  2. Refractory Skin and Soft Tissue Infections with failure to respond to maximal oral antibiotic coverage

III. Contraindications

  1. Warfarin or Heparin use

IV. Mechanism

  1. See Glycopeptide Antibiotic
  2. Decreases Bacterial cell wall synthesis
  3. Similar coverage and mechanism to Vancomycin
  4. Long-acting agents, with a single Parenteral dose covering entire antibiotic course

V. Dosing: Adults

  1. Give 1200 mg IV Infused over 3 hours for single dose
  2. Single dose may be sufficient for MRSA Cellulitis
  3. No dosing adjustment needed in moderate hepatic or renal dysfunction

VI. Disadvantages

  1. Expensive ($2500 to $9500 per single dose)

VII. Safety

  1. Pregnancy Category C
  2. Unknown Safety in Lactation

VIII. Adverse Effects

IX. Pharmacokinetics

  1. Excreted in stool
  2. Half-Life: 10 days

X. Drug Interactions

  1. Do NOT infuse with Normal Saline (incompatible)
    1. Use D5W when Flushing line
  2. Falsely elevates Coagulation Factors
    1. PTT (up to 120 hours after dose)
    2. INR (up to 12 hours after dose)
    3. Clotting time (up to 24 hours after dose)
    4. D-Dimer (up to 72 hours)

XII. References

  1. (2014) Presc Lett 21(8): 43
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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