Lipoglycopeptides

Lipoglycopeptides are not absorbed orally and are available only as IV formulations. Lipoglycopeptides penetrate well into pulmonary epithelial lining fluid and skin blisters.

Lipoglycopeptides are broadly active against gram-positive bacteria, including

• Streptococci

• Enterococcus faecalis

• 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.

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.

Common adverse effects of lipoglycopeptides include

• Nausea and vomiting

• Taste disturbance

• Foamy urine

Significant adverse effects include

• A histamine-mediated pruritus and flushing of the face, neck, and shoulders, similar to .

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

• 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