PMID- 37887199
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231029
IS  - 2079-6382 (Print)
IS  - 2079-6382 (Electronic)
IS  - 2079-6382 (Linking)
VI  - 12
IP  - 10
DP  - 2023 Sep 29
TI  - The Clinical Efficacy of Multidose Oritavancin: A Systematic Review.
LID - 10.3390/antibiotics12101498 [doi]
LID - 1498
AB  - Oritavancin (ORI) is a semisynthetic lipoglycopeptide approved as a single 1200 
      mg dose intravenous infusion for the treatment of acute bacterial skin and skin 
      structure infections (ABSSSIs) caused by Gram-positive organisms in adults. The 
      pharmacokinetic/pharmacodynamic (PK/PD) linear kinetic profile and long terminal 
      half-life (~393 h) of ORI make it therapeutically attractive for the treatment of 
      other Gram-positive infections for which prolonged therapy is needed. Multidose 
      regimens are adopted in real-world clinical practice with promising results, but 
      aggregated efficacy data are still lacking. A comprehensive search on 
      PubMed/Medline, Scopus, Cochrane and Google Scholar databases was performed to 
      include papers published up to the end of January 2023. All articles on ORI 
      multiple doses usage, including case reports, with quantitative data and relevant 
      clinical information were included. Two reviewers independently assessed papers 
      against the inclusion/exclusion criteria and for methodological quality. 
      Differences in opinion were adjudicated by a third party. From 1751 potentially 
      relevant papers identified by this search, a total of 16 studies met the 
      inclusion criteria and were processed further in the final data analysis. We 
      extracted data concerning clinical response, bacteriologic response, mortality 
      and adverse events (AEs). From the 16 included papers, 301 cases of treatment 
      with multidose ORIs were identified. Multidose regimens comprised an initial ORI 
      dose of 1200 mg followed by 1200 mg or 800 mg subsequent doses with a varying 
      total number and frequency of reinfusions. The most often treated infections and 
      isolates were osteomyelitis (148; 54.4%), ABSSSI (35; 12.9%) and cellulitis (14; 
      5.1%); and MRSA (121), MSSA (66), CoNS (17), E. faecalis (13) and E. faecium 
      (12), respectively. Clinical cure and improvement by multidose ORI regimens were 
      observed in 85% (231/272) and 8% (22/272) patients, respectively. Multidose ORI 
      was safe and well tolerated; the most frequent AEs were infusion-related 
      reactions and hypoglycemia. A multidose ORI regimen may be beneficial in treating 
      other Gram-positive infections besides ABSSSIs, with a good safety profile. 
      Further studies are warranted to ascertain the superiority of one multidose ORI 
      scheme or posology over the other.
FAU - Baiardi, Giammarco
AU  - Baiardi G
AUID- ORCID: 0000-0001-7809-077X
AD  - Pharmacology and Toxicology Unit, Department of Internal Medicine, University of 
      Genoa, 16132 Genoa, Italy.
AD  - Clinical Pharmacology Unit, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
FAU - Cameran Caviglia, Michela
AU  - Cameran Caviglia M
AUID- ORCID: 0009-0003-0973-6188
AD  - Pharmacology and Toxicology Unit, Department of Internal Medicine, University of 
      Genoa, 16132 Genoa, Italy.
AD  - Clinical Pharmacology Unit, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
FAU - Piras, Fabio
AU  - Piras F
AD  - Pharmacology and Toxicology Unit, Department of Internal Medicine, University of 
      Genoa, 16132 Genoa, Italy.
AD  - Clinical Pharmacology Unit, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
FAU - Sacco, Fabio
AU  - Sacco F
AD  - Pharmacology and Toxicology Unit, Department of Internal Medicine, University of 
      Genoa, 16132 Genoa, Italy.
AD  - Clinical Pharmacology Unit, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
FAU - Prinapori, Roberta
AU  - Prinapori R
AD  - Department of Infectious Diseases, Ente Ospedaliero Ospedali Galliera, 16128 
      Genoa, Italy.
FAU - Cristina, Maria Luisa
AU  - Cristina ML
AD  - Operating Unit Hospital Hygiene, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
AD  - Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
FAU - Mattioli, Francesca
AU  - Mattioli F
AUID- ORCID: 0000-0001-8460-0262
AD  - Pharmacology and Toxicology Unit, Department of Internal Medicine, University of 
      Genoa, 16132 Genoa, Italy.
AD  - Clinical Pharmacology Unit, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
FAU - Sartini, Marina
AU  - Sartini M
AUID- ORCID: 0000-0002-7127-2893
AD  - Operating Unit Hospital Hygiene, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, 
      Italy.
AD  - Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
FAU - Pontali, Emanuele
AU  - Pontali E
AUID- ORCID: 0000-0002-1085-0442
AD  - Department of Infectious Diseases, Ente Ospedaliero Ospedali Galliera, 16128 
      Genoa, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230929
PL  - Switzerland
TA  - Antibiotics (Basel)
JT  - Antibiotics (Basel, Switzerland)
JID - 101637404
PMC - PMC10604328
OTO - NOTNLM
OT  - clinical pharmacology
OT  - drug administration schedule
OT  - multidose regimen
OT  - oritavancin
OT  - pharmacokinetics
OT  - treatment outcome
COIS- The authors declare no conflicts of interest.
EDAT- 2023/10/27 12:43
MHDA- 2023/10/27 12:44
PMCR- 2023/09/29
CRDT- 2023/10/27 06:55
PHST- 2023/07/26 00:00 [received]
PHST- 2023/09/26 00:00 [revised]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/10/27 12:44 [medline]
PHST- 2023/10/27 12:43 [pubmed]
PHST- 2023/10/27 06:55 [entrez]
PHST- 2023/09/29 00:00 [pmc-release]
AID - antibiotics12101498 [pii]
AID - antibiotics-12-01498 [pii]
AID - 10.3390/antibiotics12101498 [doi]
PST - epublish
SO  - Antibiotics (Basel). 2023 Sep 29;12(10):1498. doi: 10.3390/antibiotics12101498.