Nuvocid (oritavancin) / Melinta Therap, Novartis, Menarini - LARVOL DELTA

ABC and MFS efflux transporters mediate antibiotic resistance and bile salt tolerance in Enterococcus faecalis. (PubMed, mSphere) - "In MIC assays, the following overexpressors also showed a twofold increase in antibiotic resistance: EF2592 and EF2593 (daptomycin, vancomycin); EF0420 (daptomycin, oritavancin); and EF1814 (daptomycin, levofloxacin, oritavancin, and vancomycin). By linking host-associated environmental stress with antimicrobial resistance phenotypes, this work advances our understanding of how gut colonization factors can influence bacterial persistence and therapeutic outcomes. The identified transporters represent potential targets for strategies to limit both intestinal colonization and antibiotic resistance in E. faecalis."

Journal • Gastrointestinal Disorder

Single-dose Antibiotics for Treatment of Skin and Soft Tissue Infections. (PubMed, Infect Dis Clin North Am) - "There are 2 long-acting lipoglycopeptides available in the United States, dalbavancin and oritavancin, which have broad gram-positive activity and significantly long-half lives, allowing for single-dose therapy. These drugs can prevent patients from requiring hospitalization for intravenous antibiotics or expedite discharge for those already admitted. They also have a role in patients with barriers to succeeding with oral antibiotics due to adherence challenges or contraindications."

Journal • Review • Infectious Disease

Oritavancin safety: a real-world pharmacovigilance study of the FAERS database. (PubMed, Front Cell Infect Microbiol) - "This real-world pharmacovigilance analysis corroborates the known labeled safety profile of oritavancin and identifies multiple underemphasized signals not fully specified in the product label, involving the neurological, respiratory, cardiovascular, and musculoskeletal systems. These disproportionality signals from spontaneous reporting reflect only statistical associations rather than definitive causality, and warrant further verification to inform clinical safety monitoring."

Adverse events • Journal • Real-world evidence • Cardiovascular • CNS Disorders • Depression • Dermatology • Infectious Disease • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry • Pulmonary Disease

Clinical efficacy and safety profile of long-acting lipoglycopeptides versus daily intravenous antibiotics for acute bacterial skin and skin structure infections (ABSSSI): a retrospective study in Greece. (PubMed, J Chemother) - "This was a retrospective, single-centre, observational study including 125 patients with skin and soft tissue infections who were either treated with LGPs such as dalbavancin or oritavancin (Group A, n = 62), or with standard daily IV therapy including vancomycin, linezolid, or daptomycin (Group B, n = 63). Furthermore, the incidence of adverse events was lower in the LGP group (Group A: 8.06% vs. Group B: 25.4%). Long-acting lipoglycopeptides demonstrated comparable clinical success rates to conventional daily intravenous antibiotics for the treatment of ABSSSI, with a 'favorable safety profile.' Moreover, the reduced cost and shorter hospitalization further support the use of LGPs as a safe and effective alternative for managing these infections."

Journal • Retrospective data • Infectious Disease

Precision Redosing of Oritavancin: A Population Pharmacokinetic Framework to Optimize Long-Term Therapy for Complex Gram-Positive Infections. (PubMed, Int J Antimicrob Agents) - "Repeated-dose oritavancin exhibits predictable PK suitable for individualized redosing. Concentrations at 24 and 168 hours provide guidance for selecting 1-, 2-, or 3-week intervals. In the absence of TDM, weekly dosing offers the highest probability of achieving PK/PD targets."

Journal • PK/PD data • Infectious Disease

Saving Beds and Budgets: Real-World Efficacy, Safety, and Pharmacoeconomics of Long-Acting Lipoglycopeptides (LALs) in a Day Hospital Setting. (PubMed, Pathogens) - "In this uncontrolled, retrospective cohort, LAL-based day hospital management was feasible and associated with favorable observed clinical outcomes, an acceptable safety profile, and a potential for cost offset in selected patients with Gram-positive infections, including complex off-label indications. Because no matched inpatient or conventional OPAT comparator was included, these findings should be regarded as hypothesis-generating and cannot establish comparative efficacy, superiority, or actual cost savings."

HEOR • Journal • Real-world evidence • Cardiovascular • Immunology • Infectious Disease • Inflammation • Rheumatology

Oritavancin as consolidation or suppressive therapy in infective endocarditis and device-related infections: real-world experience with therapeutic drug monitoring. (PubMed, JAC Antimicrob Resist) - "Multidose oritavancin appears to be a promising consolidation or suppressive strategy in selected patients with complex Gram-positive endovascular infections. Prospective studies are needed to define optimal dosing regimens and the role of TDM in this setting."

Journal • Real-world evidence • Cardiovascular • Infectious Disease

Long-Acting Lipoglycopeptide Treatment of Invasive Gram-Positive Infections. (PubMed, Drugs) - "Gram-positive infections continue to pose a therapeutic challenge owing to their invasive nature (e.g., Staphylococcus aureus and Streptococcus pyogenes) and eradication difficulties (e.g., methicillin-resistant Staphylococcus aureus [MRSA] and vancomycin-resistant enterococci [VRE])...In this article, we provide a narrative review, including the pharmacological characteristics of dalbavancin (DAL) and oritavancin (ORI), the only currently available laLGPs, as well as their approved and "off-label" use reported in the literature to date. We discuss their respective mechanism of action, caveats in compartments where they do not achieve sufficient concentrations (i.e., central nervous system [CNS]; potentially pneumonias with ORI), as well as their reported efficacy in individual organ systems as reported in literature. Lastly, we summarize insights about laLGP use in special populations and discuss the benefits of therapeutic drug monitoring of these agents,..."

Journal • Infectious Disease • Orthopedics • Pneumonia • Respiratory Diseases

Evaluation of resistance mechanisms and susceptibility testing in Enterococcus spp.: implications of vancomycin-variable isolates and optrA-mediated resistance. (PubMed, Eur J Clin Microbiol Infect Dis) - "This study provides insight into the resistance landscape and genetic diversity of clinical Enterococcus isolates. The detection of vancomycin-variable enterococci and transferable linezolid resistance determinants underscores the need for integrated phenotypic and molecular approaches to ensure accurate resistance detection and effective surveillance."

Journal • Infectious Disease

Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study. (PubMed, Pharmaceutics) - " More studies involving patients with complex infections are needed to better stablish the relationships among plasma concentrations, MIC values, and clinical outcomes. fCmin > MIC should be investigated as a potential PK/PD target for the treatment of these infections with oritavancin."

Journal • PK/PD data • Infectious Disease

Oritavancin as sequential therapy for vancomycin-resistant Enterococcus faecium prosthetic valve endocarditis: a case report. (PubMed, J Chemother) - "We report the case of a 91-year-old man with prosthetic valve endocarditis (PVE) caused by vancomycin-resistant Enterococcus faecium (VRE), successfully managed with an initial two-week course of intravenous daptomycin and fosfomycin, followed by six once-weekly outpatient infusions of oritavancin...The patient achieved complete clinical and microbiological resolution and remained relapse-free at six months of follow-up. This case highlights the feasibility of long-acting lipoglycopeptides, such as oritavancin, as sequential therapy to enable outpatient completion of prolonged treatment in selected patients with VRE prosthetic valve endocarditis."

Journal • Cardiovascular • Infectious Disease

Managing Enterococcus faecium bloodstream infection: a Delphi document on clinical recommendations and research agenda. (PubMed, EClinicalMedicine) - "Management of E faecium bloodstream infections (BSIs) remains debated, particularly the clinical impact of vancomycin resistance, the role of follow-up cultures, and optimal therapeutic regimens...For therapeutic management, teicoplanin is preferred for vanB VRE-BSI. For vanA VRE-BSI, both linezolid and high-dose daptomycin (>9 mg/kg per day) are effective, reserving daptomycin-based combinations for challenging cases (deep-seated infections and/or high Minimum Inhibitory Concentrations). Finally, future trials evaluating the impact of antimicrobial therapy should use Desirability-of-Outcome-Ranking analysis; the in-vitro potential of oritavancin justifies targeted randomized trials to define its clinical efficacy in VRE-BSI. This paper delineates current evidence and expert consensus on management of E faecium BSI while identifying crucial knowledge gaps to guide future clinical research. None."

Journal • Infectious Disease

OSCAR: Oritavancin for Treatment of Serious Cardiac Infections (clinicaltrials.gov) - P2 | N=20 | Not yet recruiting | Sponsor: Kirby Institute

New P2 trial • Cardiovascular • Infectious Disease

UK Antimicrobial Registry: Virtual Registry-an innovative surveillance approach for monitoring the real-world use and effectiveness of newly licensed antimicrobials in Scotland. (PubMed, JAC Antimicrob Resist) - "Adults (≥18 years) prescribed any of 11 RLAs (cefiderocol, ceftazidime/avibactam, ceftolozane/tazobactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, eravacycline, ceftaroline, ceftobiprole, dalbavancin, delafloxacin, oritavancin) between June 2019 and June 2023 were included. UKAR:V shows that linked electronic data can support real-world RLA surveillance. With appropriate data linkage, this model offers a scalable, low-burden approach to monitoring utilization/outcomes providing a sustainable foundation for stewardship/policy and assessment of innovative reimbursement models."

Journal • Real-world evidence • Infectious Disease • Pneumonia • Septic Shock

Drug-Drug Interactions in Recently Approved Antibacterials: A Mini Review. (PubMed, Eur J Drug Metab Pharmacokinet) - "Among the evaluated agents, cefiderocol, oritavancin, and meropenem/vaborbactam showed capacity for CYP450-mediated interactions. Oritavancin poses notable clinical concern owing to its higher degree of CYP450‑mediated interactions. Further clinical studies are warranted to validate in vitro findings to better characterize the relevance of DDIs involving these novel agents."

Journal • Review

Extrapolation of oritavancin PK/PD targets to inform therapeutic drug monitoring: a systematic review. (PubMed, J Antimicrob Chemother) - "The peculiar pharmacokinetics profile of oritavancin results in a borderline collinearity between the two PK/PD indices fCmax/MIC and %fT > MIC in relation to microbiological and clinical success rates. On the basis of available in vitro/in vivo data supporting concentration-dependent killing activity, a single 1200 mg oritavancin dose should be adequate for most infections. In special patient populations, or when multidose oritavancin regimens are adopted for long-term antibiotic treatment, therapeutic drug monitoring supported by expert clinical pharmacological advice may be valuable to optimize the initial and next-dose strategy (1200 mg or 800 mg) and to define the timing of re-administration."

Journal • PK/PD data • Review • Infectious Disease

Evaluating oritavancin for Gram-positive infections: a systematic review of on-label and off-label use. (PubMed, Drugs Context) - "Across ABSSSI randomized clinical trials, oritavancin demonstrated clinical cure rates of 79.6-83.3%, comparable to those of vancomycin. Oritavancin is effective for ABSSSI and may be a promising treatment alternative for selected Gram-positive off-label indications requiring prolonged therapy. Standardized dosing strategies and prospective trials are needed to define optimal regimens for off-label indications."

Clinical • Journal • Cardiovascular • Infectious Disease • Inflammation

Novel Vancomycin-β-Lactam Hybrids: Structure-Activity Relationships and Therapeutic Potential Against VISA and VRE. (PubMed, ChemMedChem) - "In vitro activity assays revealed that C-terminal modified vancomycin-penicillin hybrids exhibited superior efficacy, with compound 6a-6g reducing the minimum inhibitory concentration against strains such as VREs by 512-1024-fold compared to vancomycin, achieving activity comparable to oritavancin in certain strains. In vitro safety evaluations demonstrated low cytotoxicity of 6a against human kidney (HK2) and embryonic kidney (HEK293) cell lines. These findings establish 6a as a promising drug candidate, offering a novel therapeutic option for MDR infections."

Journal • Infectious Disease

Oritavancin as salvage therapy for refractory vertebral osteomyelitis: a case report (ESCMID Global 2026) - No abstract available

Case report • Clinical • Inflammation

Pharmacokinetic estimation analysis of multi-dose oritavancin for prolonged durations of therapy (ESCMID Global 2026) - No abstract available

PK/PD data

Real-world use of oritavancin for Gram-positive infections in Spain: the ORIUSE study (ESCMID Global 2026) - No abstract available

Clinical • Gram positive • Real-world • Real-world evidence • Infectious Disease

Off-label use of oritavancin: a case series on clinical effectiveness, bed-day savings and cost benefits. (PubMed, JAC Antimicrob Resist) - "Oritavancin demonstrates significant clinical effectiveness and net cost savings in the off-label treatment of complex gram-positive infections. However, limited follow-up restricts assessment of long-term outcomes."

HEOR • Journal • Infectious Disease

Oritavancin as rescue therapy in severe methicillin-resistant Staphylococcus aureus pneumonia: A case report. (PubMed, Respir Med Case Rep) - "We report the case of a 65-year-old woman with severe MRSA pneumonia, rapidly progressing to acute respiratory distress syndrome (ARDS) and apparently refractory to Linezolid and Ceftriaxone. This case highlights its potential role as rescue therapy in selected settings such as respiratory infections caused by resistant pathogens refractory to standard therapy. In critical cases with failure of standard therapeutic options, Oritavancin may represent an effective and well-tolerated off-label option for the treatment of MRSA pneumonia refractory to conventional therapy, following multidisciplinary evaluation and informed consent."

Journal • Acute Respiratory Distress Syndrome • Critical care • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Corallopyronin A exhibits potent activity against staphylococci including MRSA and isolates from prosthetic infections. (PubMed, Infection) - "CorA shows strong in vitro activity against a broad range of staphylococcal strains, particularly methicillin-resistant isolates. Its additive effects with clinically relevant antibiotics further support its potential in combination therapy for the treatment of resistant staphylococcal infections."

Journal • Infectious Disease

Oritavancin for Gram-Positive Bone and Joint Infections: A Comprehensive Review of the Literature. (PubMed, Antibiotics (Basel)) - " Current evidence suggests that oritavancin may represent an effective and well-tolerated off-label option for selected patients with Gram-positive BJIs. Its use may offer practical advantages, including reduced hospitalization and avoidance of prolonged intravenous antimicrobial therapy, particularly in patients for whom standard treatment approaches are challenging."

Journal • Review • Immunology • Infectious Disease • Inflammation • Musculoskeletal Diseases • Orthopedics • Rheumatology