Telavancin is a lipoglycopeptide antibiotic with a dual mechanism of action; it disrupts both cell wall synthesis and cell membrane integrity resulting in rapid bactericidal activity. It is active against a wide range of Gram-positive organisms, including methicillin-resistant, vancomycin-intermediate, linezolid-resistant and daptomycin-resistant Staphylococcus aureus strains. Resistance is uncommon and only occurs in vancomycin-resistant organisms of the VanA type. Its pharmacokinetic profile enables once daily administration, making it potentially suitable for use in the outpatient setting. Telavancin is renally excreted and requires dose adjustment in renal impairment. Clinical trials have demonstrated efficacy in the treatment of complicated skin and skin structure infections and nosocomial pneumonia caused by Gram-positive pathogens. This review outlines the mechanisms of action, antimicrobial spectrum, pharmacokinetics, clinical use and safety aspects of telavancin, and discusses its potential role in the antimicrobial armamentarium.
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