Lipoglycopeptide

Question 1

Mechanism of action of oritavancin

Answer 1

inhibits transpeptidation and transglycosylation. It disrupts the membrane of gram-(+) bacteria.

Question 2

Mechanism of action of telavancin

Answer 2

binds to the D-Ala-D-Ala terminus of the peptidoglycan in the growing cell wall. It inhibits transpeptidation and transglycosylation.

Question 3

Mechanism of action of dalbavancin

Answer 3

identical to vancomycin; binds to D-Ala-D-Ala residue on growing peptidoglycan chains and prevents transpeptidation and transglycosylation from occurring, thus preventing peptidoglycan elongation and cell membrane formation.

Question 4

Be able to describe the spectrum of antibacterial action of Oritavancin

Answer 4

active against a broad spectrum of gram-(+) bacteria, including MRSA.

Question 5

Be able to describe the spectrum of antibacterial action of telavancin

Answer 5

Treats MRSA and other gram-(+) infections.

Question 6

Be able to describe the spectrum of antibacterial action of dalbavancin

Answer 6

Active against a broad spectrum of gram-positive bacteria including MRSA and MRSE.

Question 7

Be able to describe how the half-lives of Dalbavancin and Oritavancin differ from those of Vancomycin and Telavancin.

Answer 7

a) Half-lives can be modulated by the lipid side chains.
b) Vancomycin: 4-6 h; Telavancin: 7-9 h
c) Dalbavancin: 204 h; Oritavancin: 245 h – these can be used in single-dose regimens.