[oritavancin photo]
KEY POINTS
- Oritavancin (Orbactiv, Kimyrsa) is a lipoglycopeptide antibiotic with concentration-dependent killing activity that works by interfering with bacterial cell wall synthesis
- First FDA approved in August 2014 and indications now include:
- Acute bacterial skin and skin structure infections
- Has activity versus Gram positive organism methicillin-resistant Staphylococcus aureus (MRSA)
- Can have activity versus vancomycin-resistant Enterococci
- Common dose is 1,200 mg intravenous as a single dose
- No dose-adjustment information available for creatinine clearance <30 mL/min or severe hepatic impairment
- Must be administered over a prolonged period of time (3 hours for Orbactiv), as infusing too quickly can result in a reaction of flushing, pruritus or urticaria
- Kimyrsa formulation “was developed to reduce intravenous infusion volume (from 1000 mL to 250 mL), shorten infusion time (from 3 hours to 1 hour), and provide pharmacies with flexibility in oritavancin preparation (from 5% dextrose in sterile water to either normal saline or 5% dextrose in sterile water) compared with the current formulation.”
- Has an exceptionally long half-life (approximately 245 hours), making one dose enough for an entire treatment course
- Dalbavancin is a drug similar to oritavancin, in that it is a lipoglycopeptide with an exceptionally long half-life (approximately 350 hours)
- Beware hypersensitivity reactions, infusion reactions, headache, nausea
- Expensive and not available in a generic formulation
RESOURCES
- Oritavancin Package Insert
- UW Health Oritavancin Protocol
- Kimyrsa, An Oritavancin-Containing Product: Clinical Study and Review of Properties (OFID 2020)
- Oritavancin for the treatment of complicated gram-positive infection in persons who inject drugs (BMC 2020)
- Activity of Oritavancin against Gram-Positive Pathogens Causing Bloodstream Infections in the United States over 10 Years: Focus on Drug-Resistant Enterococcal Subsets (2010–2019) (AAC 2022)
- Oritavancin: A Long-Half-Life Lipoglycopeptide (Clin Infect Dis 2016)
- Oritavancin, a single-dose, complete regimen, for the treatment of acute bacterial skin and skin structure infections (Expert Rev Antiinfect Ther 2015)
- Oritavancin: a review in acute bacterial skin and skin structure infections (Drugs 2015)
- Single-dose oritavancin in the treatment of acute bacterial skin infections. (NEJM 2014)
Photo source: www.orbactiv.com
