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Telavancin Adds Option for Obese Patients with SSSIs



Major Finding: Obese patients had a similar rate of cure with telavancin, compared with vancomycin (72% vs. 73%), although the rate of serious adverse events was higher with the former (11% vs. 3%).

Data Source: A post hoc analysis of data from 356 obese patients with complicated SSSIs in the phase III ATLAS trials

Disclosures: Dr. Slover is an employee of Astellas Pharma Global Development. The trials were supported jointly by Astellas Pharma Global Development and Theravance.

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CHICAGO – In obese patients, the antibiotic telavancin may offer an alternative to vancomycin for treating complicated skin and skin structure infections, according to a post hoc analysis.

In the analysis of two phase III trials, Christine M. Slover, Pharm.D., and colleagues, found that obese patients had nearly identical rates of clinical cure of their skin and skin structure infections (SSSI) whether treated with telavancin or vancomycin (72% vs. 73%). However, those in the telavancin group were more likely to have serious adverse events (11% vs. 3%).

The cure rates and adverse event rates with telavancin were generally similar to those seen in nonobese patients from the same trials, said Dr. Slover, a senior project manager at Astellas Pharma Global Development, in Deerfield, Ill.

"If you have a patient who has a complicated skin infection for whom other agents that are available might not be an option, telavancin is something you can consider, even in obese patients," Dr. Slover commented in an interview at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy.

"Telavancin is a once-a-day drug, and there is no therapeutic drug monitoring required," she added. In contrast, vancomycin is given at least twice a day and drug levels must be checked. "Cost wise, vancomycin has been available for 50 years and is generic and costs pennies a day; telavancin is a branded drug, so it does cost more because of that."

In addition, severely obese patients were 31% less likely than other obese patients and nonobese patients to achieve clinical cure of their SSSI, no matter which antibiotic they received. Such patients "have a lot of peripheral vascular disease, so it’s much harder to get the antibiotic to the sites of infection," Dr. Slover commented at the conference, which was sponsored by the American Society for Microbiology.

"If you have a patient who has a complicated skin infection for whom other agents might not be an option, telavancin is something you can consider."

The researchers analyzed data from the Assessment of Telavancin in Complicated Skin and Skin Structure Infections (ATLAS) trials, which were identical randomized, double-blind trials conducted among 1,867 adults with complicated SSSIs due to suspected or confirmed gram-positive pathogens (Clin. Infect. Dis. 2008;46:1683-93).

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