Efficacy of telavancin for treatment of surgical site infections

Introduction

The purpose of this study was to evaluate the efficacy of telavancin (TLV), a novel bactericidal lipoglycopeptide with a multifunctional mechanism of action, for the treatment of surgical site infections due to Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA).

Methods

The ATLAS program (assessment of TLV in complicated skin and skin structure infections (cSSSI)) consisted of parallel, randomized, double-blind trials including >1,800 patients with cSSSI who received either TLV 10 mg/kg intravenously every 24 hours or vancomycin (VAN) 1 g intravenously every 12 hours for 7–14 days. This subgroup analysis of ATLAS patients with surgical site cSSSI compared clinical and microbiologic responses to treatment with TLV or VAN.

Results

One hundred and ninety-four patients (10%) had operative-site cSSSI (TLV, n = 101; VAN, n = 93). Patient characteristics were similar between groups. Among all treated patients, clinical cure was achieved in 78 (77%) TLV patients and 65 (70%) VAN patients. The efficacy of TLV was numerically superior to VAN in SA and MRSA-infected patients (Table 1) but differences did not reach statistical significance. Incidences of adverse events were generally similar although nausea (28% TLV, 16% VAN), headache (10% TLV, 5% VAN) and taste disturbance (20% TLV, 1% VAN) were more common in the TLV group.

Table 1 Clinical cure and pathogen eradication rates by treatment group

Conclusion

TLV was at least as efficacious as VAN for treatment of operative-site MRSA cSSSI and is a potentially useful treatment option.