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Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
11:56

Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection

Published on: October 25, 2013

Vancomycin resistance: are there better glycopeptides coming?

Peter K Linden1

  • 1Critical Care Medicine, University of Pittsburgh Medical Center, 602 A Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA. lindenpk@ccm.upmc.edu

Expert Review of Anti-Infective Therapy
|December 5, 2008
PubMed

Insights

Vancomycin resistance in Gram-positive bacteria limits treatment options. New glycopeptides show promise against resistant strains, but their clinical efficacy for vancomycin resistance requires further study.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Vancomycin resistance in Gram-positive bacteria, especially enterococci, presents significant therapeutic challenges.
  • Clinical vancomycin treatment failures in Staphylococcus aureus infections may stem from heteroresistance.
  • Emerging resistance necessitates novel antimicrobial strategies.

Purpose of the Study:

  • To evaluate the in vitro activity, bactericidal properties, and pharmacokinetic profiles of new glycopeptides.
  • To assess the clinical efficacy and safety of these novel agents compared to existing therapies.
  • To determine the potential of new glycopeptides in addressing vancomycin resistance.

Main Methods:

  • In vitro susceptibility testing of new glycopeptides against resistant Gram-positive bacteria.
  • Pharmacokinetic and pharmacodynamic analyses of telavancin, dalbavancin, and oritavancin.
  • Review of current clinical trial data for complicated skin and skin structure infections.

Main Results:

  • Newer glycopeptides exhibit enhanced in vitro activity and bactericidal effects compared to vancomycin.
  • Clinical trials indicate noninferiority to vancomycin for specific infections with acceptable safety.
  • Unique pharmacokinetic properties differentiate these agents from older glycopeptides.

Conclusions:

  • Novel glycopeptides demonstrate improved antimicrobial properties against vancomycin-resistant pathogens.
  • Current data suggest comparable efficacy and safety for certain infections, but further investigation is needed.
  • The ultimate clinical utility of these agents in overcoming vancomycin resistance remains to be definitively established.

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