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

Publication ,  Journal Article
Rubinstein, E; Lalani, T; Corey, GR; Kanafani, ZA; Nannini, EC; Rocha, MG; Rahav, G; Niederman, MS; Kollef, MH; Shorr, AF; Lee, PC; Luna, CM ...
Published in: Clin Infect Dis
January 1, 2011

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.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

January 1, 2011

Volume

52

Issue

1

Start / End Page

31 / 40

Location

United States

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Pneumonia, Staphylococcal
  • Middle Aged
  • Microbiology
  • Methicillin-Resistant Staphylococcus aureus
  • Male
  • Lipoglycopeptides
  • Humans
  • Female
 

Citation

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Rubinstein, E., Lalani, T., Corey, G. R., Kanafani, Z. A., Nannini, E. C., Rocha, M. G., … ATTAIN Study Group. (2011). Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis, 52(1), 31–40. https://doi.org/10.1093/cid/ciq031
Rubinstein, Ethan, Tahaniyat Lalani, G Ralph Corey, Zeina A. Kanafani, Esteban C. Nannini, Marcelo G. Rocha, Galia Rahav, et al. “Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens.Clin Infect Dis 52, no. 1 (January 1, 2011): 31–40. https://doi.org/10.1093/cid/ciq031.
Rubinstein E, Lalani T, Corey GR, Kanafani ZA, Nannini EC, Rocha MG, et al. Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis. 2011 Jan 1;52(1):31–40.
Rubinstein, Ethan, et al. “Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens.Clin Infect Dis, vol. 52, no. 1, Jan. 2011, pp. 31–40. Pubmed, doi:10.1093/cid/ciq031.
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. Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis. 2011 Jan 1;52(1):31–40.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

January 1, 2011

Volume

52

Issue

1

Start / End Page

31 / 40

Location

United States

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Pneumonia, Staphylococcal
  • Middle Aged
  • Microbiology
  • Methicillin-Resistant Staphylococcus aureus
  • Male
  • Lipoglycopeptides
  • Humans
  • Female