Optimizing Therapy for Vancomycin-resistant Enterococcal Bacteremia in Children

Pranita D. Tamma; Alice J. Hsu


Curr Opin Infect Dis. 2014;27(6):517-527. 

In This Article

The Horizon

Oritavancin, dalbavancin, and tedizolid were approved by the FDA in 2014 for the treatment of acute bacterial skin and skin structure infections caused by certain Gram-positive bacteria. None of these agents have current indications for the treatment of VRE bacteremia. Oritavancin is a new lipoglycopeptide with potent in vitro activity against VRE,[179] including both E. faecalis and E. faecium.[180] Dalbavancin, another new lipoglycopeptide, maintains activity against VRE strains (E. faecalis and E. faecium) expressing vanB and vanC genes but is inactive against strains expressing vanA.[181–183] The clinical and commercial success of linezolid has prompted the development of new oxazolidinones, like tedizolid.[184] Tedizolid binds to the 23S ribosomonal RNA of bacteria with some additional structural differences which may increase its potency compared with linezolid.[185,186] In-vitro studies demonstrate activity of tedizolid against some linezolid-resistant enterococci.[187,188] As more data become available in future years, it will become clearer if any of these agents can be considered treatment options for VRE bacteremia