Overview:
The drug, Oritavancin, is an antibiotic useful in the treatment of acute bacterial skin infections caused by gram-positive bacteria. The drug has high efficacy and quick onset of action compared to its other counterparts. It is available only in the form of intravenous injections. The drug has a longer half-life, and it has demonstrated high levels of efficacy in clinical trials. The drug was first approved by the Food and Drug Administration on August 6, 2014. The drug is administered as a single dose and has been of great help in treating skin infections. The drug targets the bacterial cell wall and interferes with its formation, thereby affecting the multiplication of bacteria and its ability to pose infections. Just like other drugs, Oritavancin exhibits a few side effects like hypersensitivity, nausea, and vomiting. Understanding the drug in detail can be very useful in treating skin conditions caused by bacterial infections.
How Does Oritavancin Work?
The drug is an antibiotic that primarily belongs to the class of drugs called glycopeptide. It is known to treat serious skin infections caused by various bacteria. The drug acts by inhibiting cell wall synthesis and specifically targets the bacterial cell wall by binding to the peptidoglycan. The peptidoglycan plays an essential role in the structural integrity of bacterial cell walls. Once the drug binds to the peptidoglycan, it inhibits the transpeptidation process, which is a crucial step in bacterial cell wall synthesis, where peptide chains are cross-linked to provide cell wall stability. Inhibiting the transpeptidation process can prevent the formation of bacterial cell walls. Additionally, the drug interrupts the bacterial cell membrane and is capable of inserting into the membrane and causing depolarization and permeability. Thereby, it contributes to the antibacterial activity. The effects of the drug in inhibiting cell walls and disrupting cell membranes can cause the death of bacterial cells. However, the drug can be administered only through the intravenous route owing to its larger molecular size and extended half-life.
Uses:
The drug has various uses in treating bacterial infections. Some of the important uses are mentioned below:
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It is used in acute bacterial skin infections like cellulitis, abscess, and wounds. It is highly effective against bacteria like Staphylococcus aureus and other gram-positive pathogens.
For Patients:-
What Is Skin Infection?
An infection that affects the layer of the skin, which primarily protects the body, is referred to as a skin infection. Skin is the major barrier that prevents microorganisms like bacteria and viruses from entering the body. There are different types of skin infections which are enlisted below:
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Bacterial infection.
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Viral infections.
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Fungal infections.
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Parasitic infection.
Learn More About Oritavancin:-
When and How Often to Take Oritavancin?
Usually, the drug is administered in a single dose to treat acute bacterial skin infections. The recommended dosage is 1200 milligrams which is administered intravenously. The frequency of the dosage is crucial. Since the drug has a longer half-life, it is administered as a single dose daily. The treatment duration is completely based on the severity of the infection and the clinical judgment of the healthcare professional.
How Effective Is Oritavancin?
The drug is effective in the treatment of acute bacterial and skin infections caused by the bacteria. Various trials have established the efficacy of the drug over other antibiotics.
Things to Inform The Doctor Before They Prescribe Oritavancin:
It is better to inform the doctor regarding the previous history of allergies and medical conditions. This helps the doctor prescribe the appropriate medication by altering the dose and avoiding unwanted side effects.
Starting Oritavancin:-
How to Take Oritavancin?
The drug is usually infused intravenously in the hospital setup under the guidance of the healthcare professional.
Things to Do After Starting Oritavancin:
Look Out for Side Effects:
Some of the side effects of the drug are mentioned below:
Dietary Alterations:
The drug does not demand any specific dietary alterations. Consuming a healthy and balanced diet can benefit the overall health of an individual.
What Should Be Done When a Dose Is Missed?
In case of missing any dose, it is better to call the hospital and fix an appointment at the earliest possible. Constantly missing the doses can eventually delay the treatment process and recovery time.
What Should Be Done to Treat Oritavancin Overdose?
It is very rare to overdose on the drug if it is injected only in the hospital under the supervision of healthcare professionals.
How to Store Oritavancin?
To ensure the drug's effectiveness, it is essential to store the drug safely. The drug should be stored at a controlled room temperature of 20 degrees Celsius. Avoid exposing the drug to extreme temperatures, which can affect its stability. Also, it is essential to keep drugs away from children and pets. Do not freeze or refrigerate the drug. Always check for expiration before administering the drug.
How to Handle Oritavancin?
The drug should be handled carefully and efficiently. The health professional injects the drug intravenously by using a sterile needle to prevent contamination. Before injecting the needle, the site will be rubbed with alcohol to ensure there are no microorganisms. It is possible to feel a small prick as the needle is injected into the vein. Bruises may occur at the site of injection, which may gradually heal on its own.
How to Dispose of Oritavancin?
It is important to dispose of unused or expired medication to prevent any accidental ingestion and environmental contamination. It is best to contact a local take-back program for safe disposal of the drug. It is better to avoid flushing the drug down the toilet or pouring it into the drain. Also, it is important to remove any personal information to protect privacy.
Avoid Self-Medication:
Self-medication can be a disaster as it could cause allergies and adverse reactions. It is always safer to take the dose as per the doctor’s prescription to avoid unwanted complications.
Staying On Oritavancin:-
It is essential to continue the treatment as per the doctor’s instructions for complete recovery. Avoiding or skipping the treatment could delay the healing process.
For Doctors:-
Indication:
The drug is specifically used in adults to treat acute infections on the skin caused by bacteria. It is administered intravenously and gives a quick relief that aids with inhibiting bacterial action and sustains the growth and multiplication of the organism.
Pharmacology:
Mechanism of Action:
Oritavancin belongs to glycopeptides, which target the cell wall synthesis of the bacteria and inhibit the survival of the microorganism. The drug binds to the bacterial cell wall and inhibits the transglycosylation process. In addition, it also inhibits the transpeptidation process. This process is crucial for creating a stable cell wall. This helps to disrupt the cell wall synthesis and interrupt the peptidoglycan, which ultimately leads to the lysis of bacteria.
Pharmacodynamics:
Oritavancin pharmacodynamics is related to glycopeptide's mechanism of action. The drug is capable of targeting the bacterial cell wall and affecting its structural integrity. The other aspects of the drug include bactericidal activity and binding to the cell membrane. It weakens the bacterial cell wall and causes increased permeability and osmotic instability.
Ingredients:
Active Ingredient:
The active ingredient of the drug is Oritavancin, which is a semisynthetic lipoglycopeptide and is responsible for the therapeutic effects of the drug.
Absorption:
The drug is administered intravenously, so it gets directly infused into the bloodstream. As a result, rapid drug delivery into the systemic circulation reaches the target site. Since the drug is administered in a single dose, the concentration remains constant for a long time.
Distribution:
After administering intravenously, the drug is distributed via systemic circulation. It penetrates the soft tissues and skin to reach the target cells and exhibits an antibacterial effect. It has a high protein binding affinity and does not readily cross the blood-brain barrier. So its action in the central nervous system is limited.
Metabolism:
The drug is eliminated primarily via the urine, and a small portion may remain as inactive metabolites.
Elimination:
The drug is eliminated from the body through the kidneys. After administering intravenously, a significant portion is eliminated through urine. The elimination of the drug is relatively long due to its extended half-life; it ranges between eight to ten days in adults with normal kidney functions. Dosage adjustments may be required in adults with kidney disease or impairment to ensure the safety of the patient.
Toxicity:
The drug is usually well-tolerated when used appropriately. However, it could cause potential adverse effects, which are mentioned below:
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Infusion-related actions.
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Nausea.
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Hypersensitivity.
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Liver toxicity.
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Renal toxicity.
Dosage and Forms:
The drug is available only in the form of intravenous injection. A dosage of 1200 milligrams is administered in patients suffering from acute bacterial skin infections. It is important to follow the guidelines necessary for providing professional healthcare. This determines the appropriate dosage to be administered.
Contraindications:
Just like any other drug, Oritavancin has a few contraindications mentioned below:
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Hypersensitivity.
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Allergy.
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Increased risk of tendon disorder.
The drug can be used against gram-negative bacteria and in conditions affecting the central nervous system as the drug does not cross the blood-brain barrier. Also, it is safer to avoid using the drug in patients with failed prior treatment of the same drug.
Clinical Studies for Oritavancin:
The drug has undergone various clinical trials to prove its efficacy. The Phase III trials evaluated the efficacy of a single dose of the drug. The trial was conducted on patients with a variety of skin infections. It demonstrated a similar clinical response when compared to other antibiotics.
Drug Interactions:
Some of the drug interactions of Oritavancin are mentioned below:
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Using the drug with other antibiotics can increase the risk of side effects and hence should be avoided.
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Warfarin may affect blood clotting on interaction with Oritavancin. Hence, the prothrombin time should be carefully monitored.
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Immunosuppressants may impact drug metabolism when used in transplant patients. Hence, dose adjustments should be made to maintain the appropriate drug levels.
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Administering the drug with antacids could affect the absorption of the drug.
Other Specifications:-
Oritavancin in Pregnant Women:
The use of the drug in pregnant women should be considered carefully. It is better to take appropriate measures before recommending drug administration to avoid birth defects or congenital anomalies in children. In the case of drug administration, it is better to measure the risks and benefits before proceeding with injecting the medication.
Oritavancin in Lactating Women:
The drug is eliminated in the urine. However, there is no supporting data to prove the drug excretion in breast milk. Since there are no supporting clinical trials, caution is advised for drug administration in lactating women.
Oritavancin in Pediatric Patients:
The use of the drug in pediatric patients is not well established. There are no specific reports established relating to the safety and efficacy of the drug.
Oritavancin in Geriatric Patients:
Drug use in elderly individuals requires several factors, including co-existing medical conditions and the potential for drug interactions. Elderly individuals may experience age-related changes in drug metabolism, elimination, and distribution. The renal function may also gradually decline with age, so the dosage may be adjusted based on the individual’s renal function.
Oritavancin in Renal Impairment Patients:
A portion of the drug is eliminated through the kidneys, which affects the pharmacokinetics of the medication. Therefore, recommending the drug is based on the creatinine clearance levels. Patients with mild renal impairment do not require any dosage alterations. The recommended dosage is usually about 1200 mg and is given in intravenous infusion over three hours. However, in patients with moderate renal impairment, the dosage is roughly about 800 mg administered intravenously for over three hours.
Oritavancin in Hepatic Impairment Patients:
The drug is primarily eliminated through the liver, and this may cause hepatic impairment, which affects the pharmacokinetics of the drug. Therefore, dosage alterations may be required in patients with hepatic impairments. For example, patients suffering from moderate hepatic impairment are advised a dose of 500 mg in intravenous infusion over a span of three hours. Close monitoring of the condition is required to avoid any side effects.
