Telavancin

 Q: Telavancin should be used with caution in? (select one) 

A) Renal insufficiency 

B) Hepatic insufficiency

Answer: A

The objective of this question is to introduce readers to novel antibiotics that are used only in dire situations. Telavancin is a glycopeptide antibiotic approved by FDA for the Methicillin-resistant Staphylococcus aureus (MRSA), in Healthcare-Associated Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP). Telavancin is not the first line of antibiotics and should be used when alternative agents such as vancomycin and linezolid cannot be used. 

FDA has a black box warning for a patients who have impaired renal function. It has shown increased mortality in renally impaired patients. Renal function needs to be monitored while patients are receiving Telavancin. Also, it should be avoided in pregnancy as it may cause fetal teratogenic effects.

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References:

1. Sandrock CE, Shorr AF. The role of telavancin in hospital-acquired pneumonia and ventilator-associated pneumonia. Clin Infect Dis 2015; 61 Suppl 2:S79. 

2. Rubinstein E, Lalani T, Corey GR, et al. Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis 2011; 52:31. 

3. Corey GR, Kollef MH, Shorr AF, et al. Telavancin for hospital-acquired pneumonia: clinical response and 28-day survival. Antimicrob Agents Chemother 2014; 58:2030.