Oritavancin Brand Name– ORBACTIV
What is Oritavancin
Oritavancin is a second-generation glycopeptide antibiotic approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by certain susceptible gram-positive bacteria like Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant strains), various Streptococcus species, and Enterococcus faecalis (vancomycin-susceptible isolates).
Oritavancin inhibits bacterial cell wall biosynthesis and disrupts bacterial cell membrane integrity.
Two clinical trials demonstrated that oritavancin was as effective as vancomycin for the treatment of ABSSSI.
Unlike vancomycin, dosing is not guided by routine serum concentration measurement.
Oritavancin has been shown to artificially prolong the activated partial thromboplastin time (aPTT), prothrombin time (PT), and international normalized ratio (INR).
Use of intravenous unfractionated heparin is contraindicated for 48 hours after oritavancin administration.
Additionally, oritavancin coadministration may result in higher exposure of warfarin; therefore, oritavancin should only be used in patients receiving chronic warfarin therapy when benefit outweighs risk.
The most common adverse effects observed in clinical trials were nausea, headache, vomiting, diarrhea, and the formation of skin and soft tissue abscesses on the arms and legs.
Oritavancin was FDA-approved in August 2014.
Indications
- cellulitis
- Enterococcus faecalis
- Enterococcus faecium
- erysipelas
- skin and skin structure infections
- Staphylococcus aureus (MRSA)
- Staphylococcus aureus (MSSA)
- Streptococcus agalactiae (group B streptococci)
- Streptococcus anginosus
- Streptococcus constellatus
- Streptococcus dysgalactiae
- Streptococcus intermedius
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
Side Effects
- anemia
- angioedema
- back pain
- bronchospasm
- chest pain (unspecified)
- chills
- diarrhea
- dizziness
- elevated hepatic enzymes
- eosinophilia
- erythema
- erythema multiforme
- flushing
- headache
- hyperuricemia
- hypoglycemia
- infection
- infusion-related reactions
- myalgia
- nausea
- osteomyelitis
- peripheral edema
- phlebitis
- pruritus
- rash
- red man syndrome
- sinus tachycardia
- synovitis
- tremor
- urticaria
- vasculitis
- vomiting
- wheezing
Monitoring Parameters
- CBC with differential
Contraindications
- anticoagulant therapy
- breast-feeding
- diarrhea
- geriatric
- infusion-related reactions
- pregnancy
- pseudomembranous colitis
- vancomycin hypersensitivity
Interactions
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