Which medications in the drug class Glycopeptides are used in the treatment of Breast Abscesses and Masses?

Updated: Jul 27, 2020
  • Author: Andrew C Miller, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Glycopeptides

Vancomycin

Inpatient treatment

DOC for patients with puerperal breast abscess who are penicillin-allergic, as well as those with suspected MRSA infection. It is a potent antibiotic directed against gram­-positive organisms and active against enterococcal species. Useful in treatment of septicemia and skin structure infections. Indicated for patients who cannot receive or have failed to respond to penicillins and cephalosporins or who have infections with resistant staphylococci.

To avoid toxicity, current recommendation is to assay vancomycin trough levels after the third dose drawn 0.5 hour before next dosing. Use CrCl to adjust dose in renal impairment, prn.

Caution: Vancomycin can cross the placenta and into breast milk. Use caution in pregnant and breastfeeding mothers.

Dalbavancin (Dalvance)

Emerging treatment

Lipoglycopeptide antibiotic; interferes with cell wall synthesis by binding to D-alanyl-D-alanine terminus of the stem pentapeptide in nascent cell wall peptidoglycan, thus preventing cross­linking.

Bactericidal in vitro against S aureus and S pyogenes at concentrations observed in humans at recommended doses.

Caution: Pregnancy category C, the long half-­life of dalbavancin should be considered before using in pregnancy. Unknown if secreted in breast milk.

Oritavancin (Orbactiv)

Emerging treatment

Lipoglycopeptide antibiotic; interferes with bacteria cell wall synthesis by inhibiting transglycosidation and transpeptidation. Also disrupts the integrity of bacterial membranes, leading to cell death.

Exhibits concentration-dependent bactericidal activity against S aureus (including MRSA), Streptococcus species, and Enterococcus faecalis (not VRE).

Caution: Pregnancy category C. Unknown if distributed in human breast milk.


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