Pharmacokinetics
Lipoglycopeptides are not absorbed orally and are available only as IV formulations. Lipoglycopeptides penetrate well into pulmonary epithelial lining fluid and skin blisters.
Indications for Lipoglycopeptides
Lipoglycopeptides are broadly active against gram-positive bacteria, including
Enterococcus faecium
Staphylococcus aureus, including S. aureus
vanAvanB VRE. All three lipoglycopeptides are active against Staphylococcus aureus and Staphylococcus epidermidisS. aureus.
hospital-acquired and ventilator-acquired bacterial pneumonia caused by sensitive isolates of S. aureus.
Contraindications to Lipoglycopeptides
Use During Pregnancy and Breastfeeding
Lipoglycopeptides have had some adverse effects on fetal development in animals; safety data in pregnant women are limited. Lipoglycopeptides should be used during pregnancy only if the potential benefit to the patient outweighs the potential risk to the fetus.
There are no data regarding excretion in breast milk in humans, but lipoglycopeptides are known to be excreted in the breast milk of rats.
Adverse Effects of Lipoglycopeptides
Common adverse effects of lipoglycopeptides include
Nausea and vomiting
Taste disturbance
Foamy urine
Significant adverse effects include
Pruritus and flushing associated with rapid infusion of lipoglycopeptides can be prevented by infusing at a slower rate if the patient shows signs of flushing and pruritis.
QTc prolongation
Dosing Considerations for Lipoglycopeptides
Creatinine clearance > 50 mL/minute: 10 mg/kg IV every 24 hours
Creatinine clearance 30 to 50 mL/minute: 7.5 mg/kg every 24 hours
Creatinine clearance 10 to < 30 mL/minute: 10 mg/kg every 48 hours
Creatinine clearance < 10 mL/minute: Data limited, no recommendations available