ATLAS trials: efficacy and safety of telavancin compared with vancomycin for the treatment of skin infections.

Telavancin is an injectable lipoglycopeptide that is bactericidal in vitro against staphylococci, streptococci and vancomycin-susceptible enterococci. Telavancin inhibits bacterial cell wall synthesis by interfering with the synthesis of peptidoglycan, and binds to the bacterial membrane and disrupts membrane barrier function. The Assessment of Telavancin in cSSSI (ATLAS) program, comprising of two Phase III clinical trials, demonstrated noninferiority of telavancin to vancomycin for the treatment of complicated skin and skin-structure infections including infections due to methicillin-resistant Staphylococcus aureus (MRSA). Among clinically evaluable patients with MRSA isolated at baseline in the pooled study population, the clinical cure rate was 87.0% (208 out of 239) for patients treated with telavancin and 85.9% (225 out of 262) for patients treated with vancomycin. The most common telavancin treatment-emergent adverse events were taste disturbance, nausea, vomiting and foamy urine. Renal adverse events occurred in 3% of telavancin-treated patients and 1% of vancomycin-treated patients. Telavancin is now approved in the USA and Canada for the treatment of Gram-positive complicated skin and skin-structure infections.