Real-World Experience with Oritavancin Therapy in Invasive Gram-Positive Infections.
Real-World Experience with Oritavancin Therapy in Invasive Gram-Positive Infections.
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DOI：
10.1007/s40121-017-0156-z
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发表时间：
2017-06
影响因子：
5.4
通讯作者：
Smith JR
中科院分区：
文献类型：
--
作者：
Stewart CL;Turner MS;Frens JJ;Snider CB;Smith JR
奥利万星是一种新型脂糖肽，被批准用于治疗急性细菌性皮肤和皮肤结构感染。药代动力学特征和方便的一次性给药使奥利万星成为其他需要长期治疗的严重革兰氏阳性感染的诱人选择。不幸的是，在这些人群中使用奥利万星的数据有限。我们报告了我们卫生系统中使用奥利万星治疗侵袭性革兰氏阳性感染的十例病例，并对目前可获得的有关奥利万星治疗侵袭性感染的文献进行了综述。在接受奥利万星治疗的 10 名患者中，最常见的感染是甲氧西林敏感金黄色葡萄球菌 (MSSA) 菌血症 (n = 5, 50%)。使用奥利万星的其他适应症包括耐甲氧西林金黄色葡萄球菌 (MRSA) 滑囊炎 (n = 1, 10%)、B 族链球菌菌血症伴天然三尖瓣感染性心内膜炎 (n = 1, 10%)、凝固酶阴性葡萄球菌菌血症 (n = 1, 10%)、MSSA 深部组织感染(n = 1, 10%) 和肠球菌菌血症 (n = 1, 10%)。奥利万星耐受性良好，7/10 (70%) 患者获得成功治疗。奥利万星是侵袭性革兰氏阳性感染患者的潜在选择。需要进一步研究。
Oritavancin is a novel lipoglycopeptide approved for acute bacterial skin and skin structure infections. The pharmacokinetic profile and convenient one-time dosing make oritavancin an enticing option for other serious Gram-positive infections requiring prolonged treatment courses. Unfortunately, data for using oritavancin in these populations are limited. We report ten cases of oritavancin use for invasive Gram-positive infections in our health system, and provide a review of the currently available literature regarding oritavancin therapy for invasive infections. Among the ten patients who received oritavancin, the most common infection was methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia (n = 5, 50%). Other indications for oritavancin use included methicillin-resistant S. aureus (MRSA) bursitis (n = 1, 10%), group B streptococcal bacteremia with native tricuspid valve infective endocarditis (n = 1, 10%), coagulase-negative staphylococcal bacteremia (n = 1, 10%), MSSA deep tissue infection (n = 1, 10%), and enterococcal bacteremia (n = 1, 10%). Oritavancin was well tolerated, and 7/10 (70%) patients were successfully treated. Oritavancin is a potential option for patients with invasive Gram-positive infections. Further study is warranted.