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Antimicrobial Agents and Chemotherapy, August 2004, p. 3043-3050, Vol. 48, No. 8
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.8.3043-3050.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Pharmacodynamics of Telavancin (TD-6424), a Novel Bactericidal Agent, against Gram-Positive Bacteria

Sharath S. Hegde,* Noe Reyes, Tania Wiens, Nicole Vanasse, Robert Skinner, Julia McCullough, Koné Kaniga, John Pace, Roger Thomas, Jeng-Pyng Shaw, Glen Obedencio, and J. Kevin Judice{dagger}

Theravance, Inc., South San Francisco, California 94080

Received 1 November 2003/ Returned for modification 20 January 2004/ Accepted 6 April 2004

Telavancin (TD-6424) is a novel lipoglycopeptide that produces rapid and concentration-dependent killing of clinically relevant gram-positive organisms in vitro. The present studies evaluated the in vivo pharmacodynamics of telavancin in the mouse neutropenic thigh (MNT) and mouse subcutaneous infection (MSI) animal models. Pharmacokinetic-pharmacodynamic studies in the MNT model demonstrated that the 24-h area under the concentration-time curve (AUC)/MIC ratio was the best predictor of efficacy. Telavancin produced dose-dependent reduction of thigh titers of several organisms, including methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA), penicillin-susceptible and -resistant strains of Streptococcus pneumoniae, and vancomycin-resistant Enterococcus faecalis. The 50% effective dose (ED50) estimates for telavancin ranged from 0.5 to 6.6 mg/kg of body weight (administered intravenously), and titers were reduced by up to 3 log10 CFU/g from pretreatment values. Against MRSA ATCC 33591, telavancin was 4- and 30-fold more potent (on an ED50 basis) than vancomycin and linezolid, respectively. Against MSSA ATCC 13709, telavancin was 16- and 40-fold more potent than vancomycin and nafcillin, respectively. Telavancin, vancomycin, and linezolid were all efficacious and more potent against MRSA ATCC 33591 in the MSI model compared to the MNT model. This deviation in potency was, however, disproportionately greater for vancomycin and linezolid than for telavancin, suggesting that activity of telavancin is less affected by the immune status. The findings of these studies collectively suggest that once-daily dosing of telavancin may provide an effective approach for the treatment of clinically relevant infections with gram-positive organisms.

* Corresponding author. Mailing address: Theravance, Inc., 901 Gateway Blvd., South San Francisco, CA 94087. Phone: (650) 808-6432. Fax: (650) 808-6441. E-mail: shegde{at}theravance.com.

{dagger} Present address: Department of Medicinal Chemistry, Genentech, Inc., South San Francisco, CA 94080.

Antimicrobial Agents and Chemotherapy, August 2004, p. 3043-3050, Vol. 48, No. 8
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.8.3043-3050.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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