Telavancin (TLV)

Telavancin is a bactericidal lipoglycopeptide for use in MRSA or other Gram-positive infections. Telavancin is a semi-synthetic derivative of vancomycin. Like vancomycin, telavancin inhibits bacterial cell wall synthesis by binding to the D-Ala-D-Ala terminus of the peptidoglycan in the growing cell wall. In addition, it disrupts bacterial membranes by depolarization. Common but harmless adverse effects include nausea, vomiting, constipation, and headache. Telavancin has a higher rate of kidney failure than vancomycin in two clinical trials. It showed teratogenic effects in animal studies. Telavancin inhibits the liver enzymes CYP3A4 and CYP3A5. No data regarding the clinical relevance are available. Theravance has also submitted telavancin to the FDA in a second indication, nosocomial pneumonia, sometimes referred to as hospital-acquired pneumonia, or HAP.