Oritavancin is a long-acting
lipoglycopeptide with in vitro activity against Gram-positive pathogens, as well as good bactericidal activity and sterilisation ability in biofilm. It has been approved for acute bacterial skin and skin structure
infections (ABSSSI), but recent reports have demonstrated possible
off-label uses, such as for vancomycin resistant enterococci (VRE), deep-seated
infections including those involving prosthetic material and invasive
infections. The aim of this work is to review the uses of
oritavancin outside of ABSSSI, focusing on its real-life applications on
infective endocarditis,
catheter- or device-related
infections,
bloodstream infections, and bone and prosthetic joint
infections in humans, as well as possible future applications. We performed a narrative review, collecting the literature published between 1 December 2002 and 1 November 2022 on PubMed and the Cochrane Library using the term '
oritavancin'. Available studies have shown how effective it is in different settings, suggesting an opportunity for step-down strategies or outpatient management of
infections requiring a long duration of
antibiotic treatment. So far, evidence is still scarce, and limited to a few studies and case reports, mostly focusing on Staphylococcus aureus as the major isolate. Concerns about fluid intake for dilution and interaction with coagulation markers also need to be taken into account. Further studies are required in order to assess the safety and effectiveness of
Oritavancin in vascular, prosthetic, or device-related
infections, as well as in resistant Gram-positive bacteria or enterococcal
infections.