Telavancin: a new lipoglycopeptide with multiple mechanisms of action.

Antimicrobial resistance among Gram-positive organisms continues to increase and has reached epidemic proportions in numerous countries. Telavancin is a semisynthetic lipoglycopeptide with a dual mechanism of action that involves the inhibition of cell-wall synthesis and disruption of bacterial cell-membrane barrier functions. Telavancin exhibits a rapid bactericidal activity against Staphylococcus aureus. It is also active against coagulase-negative staphylococci, enterococci, streptococci and various anaerobic Gram-positive organisms. Telavancin has a prolonged postantibiotic effect and distributes well into cutaneous and pulmonary tissues. Furthermore, it has a low potential for development of resistance and is well tolerated. The overall incidence of adverse events in patients receiving telavancin was similar to that observed with standard therapy and recent data from preliminary clinical trials have demonstrated similar efficacy to standard therapy in the treatment of complicated skin and skin-structure infections. Therefore, telavancin is a promising new antimicrobial agent for the treatment of infections caused by resistant Gram-positive pathogens.