| Multi-drug resistant (MDR) strains of staphylococci are usually difficult to treat. Vancomycin has had a time-honored niche
in treating MDR Staphylococcus strains; however, during recent years, many clinical failures have been reported worldwide.
Since 2014, new semisynthetic lipoglycopeptides antibiotics have been introduced to combat methicillin-resistant Staphylococcus
aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-resistant Staphylococcus aureus (VRSA), and
vancomycin-resistant enterococci (VRE). They include dalbavancin, oritavancin, and telavancin. These semisynthetic lipoglycopeptides
have a considerable efficacy against MDR Staphylococcus strains. Due to the presence of a lipid side chain, the half-life is prolonged
and it enables them to anchor the cell membrane of a pathogen. Lipoglycopeptides display a greater potency and more
consistent activity against all species of staphylococci than vancomycin. Among them, oritavancin is active against MRSA, VISA, and
VRSA. However, dalbavancin and telavancin have activities against MRSA and VISA. Dalbavancin is used once weekly, telavancin is
used daily, and oritavancin is usually administered one dose per treatment. Compared to vancomycin, these semisynthetic lipoglycopeptides
have longer half-lives with a lower minimum inhibitory concentration (MIC) and rapid bactericidal activity. In addition,
lipoglycopeptides have concentration-dependent effects in vivo and in vitro. In the present paper, we review the structure, mechanism
of action, microbiology, indications, safety, and important interactions of dalbavancin, oritavancin, and telavancin. |