Telavancin is a semisynthetic derivative of lipoglycopeptide vancomycin, which is bactericidal activity against Gram positive bacteria. Telavancin inhibits cell wall synthesis and disrupts the cell membrane integrity. Pharmacology Parenteral telavancin penetrates well into the line fluid of the lung epithelium and skin blisters. Telavancin has a half-life of 7 to 9 hours and a postantibiotische effect of about 4 hours. Telavancin is excreted by the kidneys, so that its dose should be adjusted in patients with renal insufficiency. Indications telavancin is effective against gram-positive bacteria such as streptococci Enterococcus faecalis E. faecium Staphylococcus aureus, including S. aureus, which is methicillin-resistant or vancomycin-intermediate-resistant telavancin is repeated for complicated skin and skin structure infections and acquired for the hospital or through ventilation bacterial pneumonia caused by susceptible isolates of S. aureus was used. The prognosis may be worse for patients with renal insufficiency base that moderate or heavy. Contraindications telavancin is contraindicated in patients who are allergic to it. It should in patients who are allergic to vancomycin, be used with caution, as a cross-reaction is possible. Use during pregnancy and lactation telavancin has adverse effects on fetal development in animals and there are no safety data for pregnant women before, leading to an identification as a category C. There are no data on secretion found in breast milk. Side Effects Common side effects include nausea and vomiting taste disturbance Frothy urine telavancin also interferes with certain coagulation and urine protein assays. Among the significant side effects include a histamine-mediated itching and redness of the face, neck and shoulders, giving the “Red-man Syndrome” that can occur with vancomycin is similar. Nephrotoxicity may be slightly more common with telavancin than with vancomycin QTc prolongation itching and redness can be prevented by the medication is infused ? 60 minutes. QTc prolongation occurred in healthy volunteers in clinical trials of telavancin; Therefore, telavancin should be used with caution or not in patients who are taking medications that prolong the QT interval. Telavancin should not be used in patients with congenital long QT syndrome, known QTc prolongation, uncompensated heart failure, or severe left ventricular hypertrophy (patients with these disorders were excluded from clinical trials). Considerations Dosage The dosage of telavancin based on the creatinine clearance: creatinine clearance of> 50 ml / min: 10 mg / kg i.v. every 24 h creatinine clearance of 30 to 50 ml / min: 7.5 mg / kg every 24 h creatinine clearance of 10 to <30 ml / min: 10 mg / kg every 48 h creatinine clearance <10 mL / min : insufficient data, no recommendations available

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