II. Indications
- See Glycopeptide Antibiotic
- Complicated Skin Infections (including MRSA)
- Hospital acquired or Ventilator associated Staphylococcus aureusPneumonia
- Not considered a first-line agent (other agents are preferred)
III. Contraindications
- eGFR <50 ml/min
- Mortality increased in Hospital Acquired Pneumonia (including Ventilator associated) compared with Vancomycin
- Known QT Prolongation (e.g. congenital, Drug-Induced QTc Prolongation)
- Decompensated Heart Failure
- Severe Left Ventricular Hypertrophy
- Unfractionated Heparin use (caution with Warfarin use)
IV. Mechanism
V. Dosing
- IV formulation must be infused within 4 hours when left at room Temperature
- Standard Dosing (eGFR>50 ml/min)
- Give 10 mg/kg IV infused over 1 hour once daily for 7 to 14 days in Skin Infections (up to 21 days in Pneumonia)
-
Renal Dosing (eGFR<50 ml/min)
- Telavancin is NOT recommended when eGFR<50 ml/min (see adverse effects and contraindications)
- eGFR 30 to 50 ml/min: 7.5 mg/kg IV every 24 hours
- eGFR 10 to 29 ml/min: 10 mg/kg IV every 48 hours
VI. Adverse Effects
- See Glycopeptide Antibiotic
- QT Prolongation
- Nephrotoxic
- Monitor Renal Function every 2 to 3 days
- Avoid in eGFR <50 ml/min
- Accumulation of cyclodextrin carrier in renal dysfunction
VII. Safety
VIII. Drug Interactions
- Drug-Induced QTc Prolongation
- Falsely elevates coagulation studies (e.g. PTT, INR, Activated Clotting Time) for up to 18 hours after last dose
IX. Resources
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Lacy (2000) Drug Information Handbook, Lexi-Comp
- (2014) Presc Lett 21(8): 43