Telavancin is a lipoglycopeptide antibiotic designed to combat severe bacterial infections. This medication plays an important role in fighting strains of bacteria that have developed resistance to more commonly used antibiotics, making it a valuable option when other treatments are less effective.
What Telavancin Treats
Telavancin is approved for treating serious bacterial infections caused by susceptible Gram-positive bacteria. This includes complicated skin and skin structure infections (cSSSI) and certain types of pneumonia, such as hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP). These infections can be particularly challenging, especially when caused by resistant organisms.
A significant focus for telavancin is its activity against Methicillin-resistant Staphylococcus aureus (MRSA), a common and often difficult-to-treat bacterium. It also demonstrates activity against vancomycin-intermediate Staphylococcus aureus (VISA) and heteroresistant VISA (hVISA) strains. Telavancin is generally considered for use when other antibiotics are not suitable or have been ineffective.
How Telavancin Works and Is Administered
Telavancin operates through a dual mechanism to eliminate bacteria. It works by inhibiting bacterial cell wall synthesis, a process similar to how vancomycin functions, where it binds to specific precursors in the cell wall to prevent their proper formation. This action disrupts the construction of the bacterial protective outer layer.
Beyond cell wall inhibition, telavancin also disrupts the integrity of the bacterial cell membrane. This disruption leads to depolarization of the membrane and increased permeability, causing leakage of essential cellular components and ultimately bacterial death. This combined approach makes telavancin a potent bactericidal agent.
The medication is administered intravenously (IV) as an infusion, typically given once daily. Each infusion usually takes about 60 minutes. Due to the serious nature of the infections it treats, telavancin is generally given in a hospital setting or under close medical supervision.
Potential Side Effects and Important Warnings
Telavancin can cause side effects, ranging from common and mild to more serious reactions. Common side effects include nausea, vomiting, a metallic or soapy taste, headache, and foamy urine. Patients may also experience diarrhea, dizziness, or a rash.
More serious side effects warrant immediate medical attention. These include kidney problems, such as little or no urinating, swelling in the ankles or feet, or weight gain. Telavancin can also prolong the QTc interval, a measure of heart’s electrical activity, which could lead to heart rhythm issues. Another serious reaction is Red Man Syndrome, characterized by flushing of the upper body, itching, or rash, often associated with rapid infusion, similar to reactions seen with vancomycin.
Important Warnings
Patients with existing kidney impairment may require dose adjustments, as the drug is primarily eliminated through the kidneys, and its efficacy can decrease with moderate-to-severe renal impairment. Telavancin is contraindicated in pregnant women due to potential fetal harm, and females of reproductive potential should use effective contraception during and for two days after the last dose.
There is potential for drug interactions, especially with medications that affect kidney function or heart rhythm. For instance, telavancin may interfere with certain laboratory tests used to monitor heparin effectiveness. Hypersensitivity reactions, including severe allergic responses like anaphylaxis, are also possible. Patients should provide their complete medical history and a list of all current medications to their healthcare provider before beginning telavancin treatment.