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Experience with expanded use of oritavancin in a tertiary hospital: indications, tolerability and outcomes
Thilinie Dulanjalee Bandaranayake1, Christopher Radcliffe1, Melanie Cvercko2
1Section of Infectious Diseases, Yale School of Medicine, TAC S 169, PO BOX 208022, New Haven, CT 06520, USA.
Background:
Oritavancin is a lipoglycopeptide antibacterial agent used to treat infections caused by Gram-positive organisms. It is FDA-approved for the treatment of acute bacterial skin and soft tissue infections (ABSSIs) but is increasingly being used off-label to treat invasive bacterial infections such as osteomyelitis, prosthetic joint infection and infective endocarditis.
Objectives:
This study describes the clinical outcomes and adverse reactions related to oritavancin.
Patients And Methods:
This was a retrospective study conducted over a 5 year period at a tertiary care medical centre. Ninety-five adult patients were included in this study and were followed for 1 year after the last dose of oritavancin.
Results:
The most common indication for oritavancin at our institution was osteomyelitis, followed by ABSSI. Other indications were vertebral infection, hardware-associated infection, bacteraemia and infective endocarditis. Fourteen percent (13/95) of patients developed an adverse reaction to oritavancin during the study period. Cure with no recurrence up to 1 year after the last dose of oritavancin was achieved in 74% (53/71) of patients, and the treatment failure rate was 19% (14/71 patients).
Conclusions:
Oritavancin is an effective agent that can be used to treat invasive Gram-positive bacterial infections other than ABSSI. Adverse events requiring drug discontinuation were common.
Insights
Oritavancin effectively treats invasive Gram-positive infections beyond skin infections, with a 74% cure rate. However, adverse events requiring discontinuation were common in this study.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Oritavancin is a lipoglycopeptide antibiotic approved for acute bacterial skin and soft tissue infections (ABSSIs).
- It is increasingly used off-label for invasive Gram-positive bacterial infections, including osteomyelitis and infective endocarditis.
Purpose of the Study:
- To evaluate the clinical outcomes and adverse reactions of oritavancin in patients with various Gram-positive bacterial infections.
- To assess the long-term efficacy and safety of oritavancin in a real-world setting.
Main Methods:
- A retrospective study conducted over 5 years at a tertiary care medical center.
- Ninety-five adult patients receiving oritavancin were followed for one year post-treatment.
Main Results:
- Osteomyelitis was the most frequent indication, followed by ABSSIs.
- A cure rate of 74% was observed, with a 19% treatment failure rate.
- Fourteen percent of patients experienced adverse reactions requiring drug discontinuation.
Conclusions:
- Oritavancin demonstrates efficacy in treating invasive Gram-positive infections beyond ABSSIs.
- While effective, adverse events necessitating discontinuation are a notable concern.
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