II. Indications

  1. See Glycopeptide Antibiotic
  2. Complicated Skin Infections (including MRSA)
  3. Hospital acquired or Ventilator associated Staphylococcus aureusPneumonia
    1. Not considered a first-line agent (other agents are preferred)

III. Contraindications

  1. eGFR <50 ml/min
    1. Mortality increased in Hospital Acquired Pneumonia (including Ventilator associated) compared with Vancomycin
  2. Known QT Prolongation (e.g. congenital, Drug-Induced QTc Prolongation)
  3. Decompensated Heart Failure
  4. Severe Left Ventricular Hypertrophy
  5. Unfractionated Heparin use (caution with Warfarin use)

IV. Mechanism

V. Dosing

  1. IV formulation must be infused within 4 hours when left at room Temperature
  2. Standard Dosing (eGFR>50 ml/min)
    1. 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)
  3. Renal Dosing (eGFR<50 ml/min)
    1. Telavancin is NOT recommended when eGFR<50 ml/min (see adverse effects and contraindications)
    2. eGFR 30 to 50 ml/min: 7.5 mg/kg IV every 24 hours
    3. eGFR 10 to 29 ml/min: 10 mg/kg IV every 48 hours

VI. Adverse Effects

  1. See Glycopeptide Antibiotic
  2. QT Prolongation
  3. Nephrotoxic
    1. Monitor Renal Function every 2 to 3 days
    2. Avoid in eGFR <50 ml/min
    3. Accumulation of cyclodextrin carrier in renal dysfunction

VII. Safety

  1. Unknown safety in Lactation
  2. Teratogenic in animals
    1. Avoid in pregnancy (despite pregnancy category C)

VIII. Drug Interactions

  1. Drug-Induced QTc Prolongation
  2. Falsely elevates coagulation studies (e.g. PTT, INR, Activated Clotting Time) for up to 18 hours after last dose

X. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Lacy (2000) Drug Information Handbook, Lexi-Comp
  3. (2014) Presc Lett 21(8): 43

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