Affiliation:
1. Scientific Centre for Expert Evaluation of Medicinal Products
Abstract
In recent years, glycopeptide antibiotics have been widely used to treat severe bacterial infections. The long-term use of first-generation antibiotics of this group (vancomycin, teicoplanin) has contributed to the emergence of bacteria resistant to them. The problem of resistance has motivated the development of three new glycopeptide antibiotics: dalbavancin, telavancin, and oritavancin. The aim of this study was to consolidate and analyse the data from literature and current quality standards related to glycopeptide antibiotics. The article presents basic information about the discovery of glycopeptide antibiotics of natural origin (vancomycin, teicoplanin) and their derivatives (telavancin, oritavancin, dalbavancin). It briefly characterises the structures of the glycopeptide antibiotics under consideration and describes their main properties, application, and distribution in the pharmaceutical market. The article also gives information on the spectra of antibacterial activity of vancomycin, teicoplanin, and their semi-synthetic derivatives. It considers approaches to vancomycin and teicoplanin standardisation and covers the main requirements of leading pharmacopoeias for the quality of vancomycin, teicoplanin, and the corresponding medicinal products. According to the study results, glycopeptide antibiotics are still widely prescribed because of their high effectiveness in diseases caused by Gram-positive bacteria. However, at present, leading pharmacopoeias have developed and implemented quality standards only for two antibiotics of the group: vancomycin and teicoplanin. According to the results of literature consolidation, further modification of glycopeptide antibiotics is aimed at creating compounds characterised by prolonged action and greater effectiveness against pathogenic microorganisms. Thus, the attention of researchers should be directed to further standardisation of the newest derivatives of glycopeptide antibiotics: telavancin, oritavancin, and dalbavancin.
Reference22 articles.
1. Levin DP. Vancomycin: a history. Clin Infect Dis. 2006; 42 Suppl 1:S5–12. https://doi.org/10.1086/491709
2. Phillips-Jones MK, Lithgo R, Dinu V, Gillis RB, Harding JE, Adams GG, Harding SE. Full hydrodynamic reversibility of the weak dimerization of vancomycin and elucidation of its interaction with VanS monomers at clinical concentration. Sci Rep. 2017;7(1):12697. https://doi.org/10.1038/s41598-017-12620-z
3. Zeng D, Debabov D, Hartsell TL, Cano RJ, Adams S, Schuyler JA, et al. Approved glycopeptide antibacterial drugs: mechanism of action and resistance. Cold Spring Harb Perspect Med. 2016;6(12):a026989. https://doi.org/10.1101/cshperspect.a026989
4. Lambert M. IDSA Guidelines on the treatment of MRSA infections in adults and children. Am Fam Physician. 2011;84(4):455–63.
5. Blatun LA, Krutikov MG, Grishina IA, Bobrovnikov AE, Alekseev AA, Svetukhin AM. Clinical and laboratory evaluation of vancomycin (Edicin®) efficacy in the treatment of purulent wounds of the skin and soft tissues, burn wounds and infectious complications of burn disease. Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy. 2000;45(2):22–7 (In Russ.)