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Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
Published on: October 25, 2013
Vancomycin resistance: are there better glycopeptides coming?
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
Summary
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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