Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis.
INTRODUCTION: The epidemiology and antibiotic resistance of Staphylococcus aureus have evolved, underscoring the need for novel antibiotics, particularly against methicillin-resistant S. aureus (MRSA). Telavancin is a bactericidal lipoglycopeptide with potent activity against Gram-positive pathogens...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3420911?pdf=render |
| _version_ | 1818822039792779264 |
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| author | Konstantinos A Polyzos Michael N Mavros Konstantinos Z Vardakas Marinos C Makris Petros I Rafailidis Matthew E Falagas |
| author_facet | Konstantinos A Polyzos Michael N Mavros Konstantinos Z Vardakas Marinos C Makris Petros I Rafailidis Matthew E Falagas |
| author_sort | Konstantinos A Polyzos |
| collection | DOAJ |
| description | INTRODUCTION: The epidemiology and antibiotic resistance of Staphylococcus aureus have evolved, underscoring the need for novel antibiotics, particularly against methicillin-resistant S. aureus (MRSA). Telavancin is a bactericidal lipoglycopeptide with potent activity against Gram-positive pathogens. OBJECTIVE: To systematically review and synthesize the available evidence from randomized controlled trials (RCTs) evaluating telavancin in the treatment of patients with infections due to Gram-positive organisms with the methodology of meta-analysis. RESULTS: Six RCTs comparing telavancin with vancomycin were included; 4 (2229 patients) referred to complicated skin and soft tissue infections (cSSTIs) and 2 (1503 patients) to hospital-acquired pneumonia (HAP). Regarding cSSTIs, telavancin and vancomycin showed comparable efficacy in clinically evaluable patients (odds ratio [OR] =1.10 [95% confidence intervals: 0.82-1.48]). Among patients with MRSA infection, telavancin showed higher eradication rates (OR=1.71 [1.08-2.70]) and a trend towards better clinical response (OR=1.55 [0.93-2.58]). Regarding HAP, telavancin was non-inferior to vancomycin in terms of clinical response in two Phase III RCTs; mortality rates for the pooled trials were comparable with telavancin (20%) and vancomycin (18.6%). Pooled data from cSSTIs and HAP studies on telavancin 10 mg/kg indicated higher rates of serum creatinine increases (OR=2.22 [1.38-3.57]), serious adverse events (OR=1.53 [1.05-2.24]), and adverse event-related withdrawals (OR=1.49 [1.14-1.95]) among telavancin recipients. CONCLUSION: Telavancin might be an alternative to vancomycin in cases of difficult-to-treat MRSA infections. The potent antistaphylococcal activity of telavancin should be weighted against the potential for nephrotoxicity. |
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| format | Article |
| id | doaj.art-35138a0ed5864bc1b0ffe1aa541a85fa |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-18T23:17:45Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-35138a0ed5864bc1b0ffe1aa541a85fa2022-12-21T20:48:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0178e4187010.1371/journal.pone.0041870Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis.Konstantinos A PolyzosMichael N MavrosKonstantinos Z VardakasMarinos C MakrisPetros I RafailidisMatthew E FalagasINTRODUCTION: The epidemiology and antibiotic resistance of Staphylococcus aureus have evolved, underscoring the need for novel antibiotics, particularly against methicillin-resistant S. aureus (MRSA). Telavancin is a bactericidal lipoglycopeptide with potent activity against Gram-positive pathogens. OBJECTIVE: To systematically review and synthesize the available evidence from randomized controlled trials (RCTs) evaluating telavancin in the treatment of patients with infections due to Gram-positive organisms with the methodology of meta-analysis. RESULTS: Six RCTs comparing telavancin with vancomycin were included; 4 (2229 patients) referred to complicated skin and soft tissue infections (cSSTIs) and 2 (1503 patients) to hospital-acquired pneumonia (HAP). Regarding cSSTIs, telavancin and vancomycin showed comparable efficacy in clinically evaluable patients (odds ratio [OR] =1.10 [95% confidence intervals: 0.82-1.48]). Among patients with MRSA infection, telavancin showed higher eradication rates (OR=1.71 [1.08-2.70]) and a trend towards better clinical response (OR=1.55 [0.93-2.58]). Regarding HAP, telavancin was non-inferior to vancomycin in terms of clinical response in two Phase III RCTs; mortality rates for the pooled trials were comparable with telavancin (20%) and vancomycin (18.6%). Pooled data from cSSTIs and HAP studies on telavancin 10 mg/kg indicated higher rates of serum creatinine increases (OR=2.22 [1.38-3.57]), serious adverse events (OR=1.53 [1.05-2.24]), and adverse event-related withdrawals (OR=1.49 [1.14-1.95]) among telavancin recipients. CONCLUSION: Telavancin might be an alternative to vancomycin in cases of difficult-to-treat MRSA infections. The potent antistaphylococcal activity of telavancin should be weighted against the potential for nephrotoxicity.http://europepmc.org/articles/PMC3420911?pdf=render |
| spellingShingle | Konstantinos A Polyzos Michael N Mavros Konstantinos Z Vardakas Marinos C Makris Petros I Rafailidis Matthew E Falagas Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. PLoS ONE |
| title | Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. |
| title_full | Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. |
| title_fullStr | Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. |
| title_full_unstemmed | Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. |
| title_short | Efficacy and safety of telavancin in clinical trials: a systematic review and meta-analysis. |
| title_sort | efficacy and safety of telavancin in clinical trials a systematic review and meta analysis |
| url | http://europepmc.org/articles/PMC3420911?pdf=render |
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