Abstract:
Oritavancin is a long-acting lipoglycopeptide with in vitro activity against Gram-positive pathogens, as well as good bactericidal activity and sterilisation ability in biofilm. It has been approved for acute bacterial skin and skin structure infections (ABSSSI), but recent reports have demonstrated possible off-label uses, such as for vancomycin resistant enterococci (VRE), deep-seated infections including those involving prosthetic material and invasive infections. The aim of this work is to review the uses of oritavancin outside of ABSSSI, focusing on its real-life applications on infective endocarditis, catheter- or device-related infections, bloodstream infections, and bone and prosthetic joint infections in humans, as well as possible future applications. We performed a narrative review, collecting the literature published between 1 December 2002 and 1 November 2022 on PubMed and the Cochrane Library using the term \'oritavancin\'. Available studies have shown how effective it is in different settings, suggesting an opportunity for step-down strategies or outpatient management of infections requiring a long duration of antibiotic treatment. So far, evidence is still scarce, and limited to a few studies and case reports, mostly focusing on Staphylococcus aureus as the major isolate. Concerns about fluid intake for dilution and interaction with coagulation markers also need to be taken into account. Further studies are required in order to assess the safety and effectiveness of Oritavancin in vascular, prosthetic, or device-related infections, as well as in resistant Gram-positive bacteria or enterococcal infections.
摘要:
Oritavancin是一种长效脂糖肽,具有抗革兰氏阳性病原体的体外活性,以及在生物膜中具有良好的杀菌活性和杀菌能力。它已被批准用于急性细菌性皮肤和皮肤结构感染(ABSSSI),但是最近的报告显示了可能的标签外用途,例如耐万古霉素肠球菌(VRE),深层感染,包括涉及假体材料和侵入性感染的感染。这项工作的目的是审查oritavancin在ABSSSI之外的用途,专注于其在感染性心内膜炎的实际应用,导管或器械相关感染,血流感染,人类的骨骼和人工关节感染,以及未来可能的应用。我们进行了叙述性审查,收集2002年12月1日至2022年11月1日在PubMed和Cochrane图书馆使用术语“oritavancin”发表的文献。现有的研究表明,它在不同的环境中是多么有效,提示需要长期抗生素治疗的感染的逐步减少策略或门诊管理的机会。到目前为止,证据仍然很少,仅限于一些研究和案例报告,主要集中在金黄色葡萄球菌作为主要分离株。还需要考虑对稀释的流体摄入以及与凝血标记物的相互作用的担忧。需要进一步的研究,以评估奥利万星在血管中的安全性和有效性,假肢,或设备相关感染,以及耐药革兰氏阳性细菌或肠球菌感染。