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Oritavancin: A Review in Acute Bacterial Skin and Skin Structure Infections

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Abstract

Oritavancin (Orbactiv®) is a new generation lipoglycopeptide approved for use in adult patients with acute bacterial skin and skin structure infections (ABSSSI). It is administered as a single 1200 mg intravenous infusion over 3 h. In phase 3 trials in adult patients with ABSSSI, oritavancin was noninferior to vancomycin in terms of a composite outcome (cessation of spreading or reduction in the size of the baseline lesion, absence of fever and no rescue antibacterials required; primary endpoint) assessed at an US FDA-recommended early timepoint of 48–72 h after initiation of treatment. Oritavancin was also noninferior to vancomycin in terms of a ≥20 % reduction in the baseline lesion size at the early timepoint and clinical cure rate 7–14 days after the end of treatment. Oritavancin was generally well tolerated in the phase 3 trials, with most treatment-emergent adverse reactions being mild in severity. The most common adverse events occurring in oritavancin recipients were nausea, headache, vomiting, limb and subcutaneous abscesses, and diarrhoea. Oritavancin offers a number of potential advantages, including a convenient single dose treatment that may shorten or eliminate hospital stays, a reduction in healthcare resource utilization and cost, no need for dosage adjustment in patients with mild to moderate hepatic or renal impairment, no need for therapeutic drug monitoring, and elimination of compliance concerns. Therefore, oritavancin is a useful treatment option for adults with ABSSSI.

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Acknowledgments

During the peer review process, the manufacturer of oritavancin was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Yahiya Y. Syed & Lesley J. Scott

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The preparation of this review was not supported by any external funding.

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Yahiya Syed and Lesley Scott are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

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The manuscript was reviewed by: N. E. Holmes, Department of Infectious Diseases, Austin Health, Heidelberg, Australia; R. N. Jones, JMI Laboratories, North Liberty, IA, USA; B. M. Lomaestro, Department of Pharmacy, Albany Medical Center Hospital, Albany, NY, USA; C. V. Pollack, Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA; K. A. Rodvold, Colleges of Pharmacy and Medicine, University of Illinois at Chicago, Chicago, IL, USA; F. Van Bambeke, Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.

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Syed, Y.Y., Scott, L.J. Oritavancin: A Review in Acute Bacterial Skin and Skin Structure Infections. Drugs 75, 1891–1902 (2015). https://doi.org/10.1007/s40265-015-0478-7

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