Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens.

Published

Journal Article

BACKGROUND: Telavancin is a lipoglycopeptide bactericidal against gram-positive pathogens. METHODS: Two methodologically identical, double-blind studies (0015 and 0019) were conducted involving patients with hospital-acquired pneumonia (HAP) due to gram-positive pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA). Patients were randomized 1:1 to telavancin (10 mg/kg every 24 h) or vancomycin (1 g every 12 h) for 7-21 days. The primary end point was clinical response at follow-up/test-of-cure visit. RESULTS: A total of 1503 patients were randomized and received study medication (the all-treated population). In the pooled all-treated population, cure rates with telavancin versus vancomycin were 58.9% versus 59.5% (95% confidence interval [CI] for the difference, -5.6% to 4.3%). In the pooled clinically evaluable population (n = 654), cure rates were 82.4% with telavancin and 80.7% with vancomycin (95% CI for the difference, -4.3% to 7.7%). Treatment with telavancin achieved higher cure rates in patients with monomicrobial S. aureus infection and comparable cure rates in patients with MRSA infection; in patients with mixed gram-positive/gram-negative infections, cure rates were higher in the vancomycin group. Incidence and types of adverse events were comparable between the treatment groups. Mortality rates for telavancin-treated versus vancomycin-treated patients were 21.5% versus 16.6% (95% CI for the difference, -0.7% to 10.6%) for study 0015 and 18.5% versus 20.6% (95% CI for the difference, -7.8% to 3.5%) for study 0019. Increases in serum creatinine level were more common in the telavancin group (16% vs 10%). CONCLUSIONS: The primary end point of the studies was met, indicating that telavancin is noninferior to vancomycin on the basis of clinical response in the treatment of HAP due to gram-positive pathogens.

Full Text

Duke Authors

Cited Authors

  • Rubinstein, E; Lalani, T; Corey, GR; Kanafani, ZA; Nannini, EC; Rocha, MG; Rahav, G; Niederman, MS; Kollef, MH; Shorr, AF; Lee, PC; Lentnek, AL; Luna, CM; Fagon, J-Y; Torres, A; Kitt, MM; Genter, FC; Barriere, SL; Friedland, HD; Stryjewski, ME; ATTAIN Study Group,

Published Date

  • January 1, 2011

Published In

Volume / Issue

  • 52 / 1

Start / End Page

  • 31 - 40

PubMed ID

  • 21148517

Pubmed Central ID

  • 21148517

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

Digital Object Identifier (DOI)

  • 10.1093/cid/ciq031

Language

  • eng

Conference Location

  • United States