Lipoglycopeptide Antibiotics
Also known as: Dalbavancin (Dalvance), Oritavancin (Orbactiv), Oritavancin (Kimyrsa), Telavancin (Vibativ)
Vancomycin-derived antibiotics (dalbavancin, oritavancin, telavancin) for gram-positive infections, incl. MRSA. FDA-approved. Prescription only.
Last updated
Mechanism of Action
Lipoglycopeptides are semisynthetic relatives of vancomycin with an added lipophilic side chain. Like vancomycin they bind D-alanyl-D-alanine peptidoglycan precursors to block cell-wall synthesis; the lipid tail anchors them to the bacterial membrane and, for oritavancin and telavancin, also disrupts membrane integrity. Dalbavancin and oritavancin have very long half-lives, which allows one or two doses to cover a full course.
- Half-life
- Dalbavancin ~14 days; oritavancin ~10 days; telavancin ~8 hours
- Administration Routes
- Intravenous
- Research Status
- Clinical
Reported Benefits
- Treat acute bacterial skin and skin-structure infections, including MRSA (all three)
- Single-dose or two-dose courses (dalbavancin, oritavancin) can shorten hospital stays
- Telavancin is approved for hospital-acquired and ventilator-associated S. aureus pneumonia when alternatives aren't suitable
Potential Side Effects
- Nausea, headache and diarrhea
- Infusion reactions
- Telavancin boxed warnings: fetal risk, kidney toxicity, and higher mortality in pneumonia patients with pre-existing kidney impairment
- Oritavancin falsely prolongs some clotting tests (aPTT, PT/INR) for days
- Liver enzyme elevations (dalbavancin)
Common Dosing
These are hospital or infusion-center drugs given intravenously by clinicians. Dalbavancin and oritavancin are given as one or two infusions for a skin infection; telavancin is given once daily, adjusted for kidney function. The prescribing clinician sets and supervises dosing.
The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.
Contraindications
- Known hypersensitivity to glycopeptides (cross-reactivity with vancomycin is possible)
- Oritavancin: IV unfractionated heparin is contraindicated for a period after dosing because of clotting-test interference
- Telavancin: avoid in pregnancy unless benefit outweighs risk; caution in kidney impairment
No documented stacking partners for Lipoglycopeptide Antibiotics yet.
- View
Once-weekly dalbavancin versus daily conventional therapy for skin infection
2014
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Single-dose oritavancin in the treatment of acute bacterial skin infections
2014
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Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens
2011
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Dalbavancin for Treatment of Staphylococcus aureus Bacteremia: The DOTS Randomized Clinical Trial
2025