Telavancin (Vibativ)
Started by Sparda29
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I think it may eventually have a role in the treatment of VRE endocarditis. Daptomycin + vanco = useful, in my book.
Aside from that, not so much. Another renally excreted anti-MRSA/VRE agent just isn't all that necessary right now. Unless it displays drastically different resistance patterns than other agents on the market, I'm not sure it will ever catch on.
I could also be speaking out of my ass right now.
Aside from that, not so much. Another renally excreted anti-MRSA/VRE agent just isn't all that necessary right now. Unless it displays drastically different resistance patterns than other agents on the market, I'm not sure it will ever catch on.
I could also be speaking out of my ass right now.
You are.
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F***K no.
No use at all? Come on...
Their drug reps agree with you, though.
http://www.cafepharma.com/boards/showthread.php?t=413138
I had never heard of it, but here's a Wiki article about it.
http://en.wikipedia.org/wiki/Telavancin
http://en.wikipedia.org/wiki/Telavancin
lol
We don't have it at my VA. Too expensive and no real advantage over other, cheaper drugs.
All drug reps can go to hell. They serve no purpose in healthcare. I also heard 20% physicians in the US are affiliated with pharma. Well, that's because physicians can be bribed. The FDA really can't be bribed..at least not that I know of.
That being said.. show me where Telavancin is superior over Vanco.. also show me the cost benefit and convince me.
Yes, but we didn't stock it, nor did I see any drug rep information about it that I can remember. Do keep in mind that I've been out of the official loop for 5 months as of tomorrow. 🙁
Except for one in particular who would bring us homemade desserts, and I genuinely liked him as a person too.
They even came to the Indian reservation where I did rotations! Why, I don't know, because our formulary was dictated by the Federal government. My preceptor would take all the free doodads, then go to the sink after they left and do a surgical scrub of his arms.
For VRE endo it's going to be better than Vanco. Whether it's better than anything else out there for that indication remains to be seen, and I think it will take a long time before anyone starts using telavancin over dapto to generate that data. I would be willing to bet though that it would be better than linezolid.
I don't know what it's price is relative Cubicin or Zyvox, and I'm sure that will end up driving a lot of its use.
It's pretty new. I already know about it since I had to write a monograph about it. Personally, I wouldn't keep it on formulary unless they find it to be effective against vancomycin resistant bugs. Cost is like $180/day for Telavancin while Vanco costs like $10.
Have the prices on my laptop, but the laptop isn't with me right now. I do remember it being cheaper than Cubicin and cheaper than oral Zyvox.
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Except for one in particular who would bring us homemade desserts, and I genuinely liked him as a person too.
They even came to the Indian reservation where I did rotations! Why, I don't know, because our formulary was dictated by the Federal government. My preceptor would take all the free doodads, then go to the sink after they left and do a surgical scrub of his arms.
u-huh, and the rep did all that from the goodness of his heart I bet...and didn't even expense any of that I bet.
So you can see how easy one can be bought??
Hell no.
They were usually made with cake mix, instant pudding, and chocolate or butterscotch chips; he would leave us the recipe.
He repped Seroquel XR, and we would always have a spike in ordering it for 2 or 3 days after he came by, and then it would drop off dramatically. In any case, we all still liked him. Most of the others? No, especially the 50-something woman who would show up in a leather micro-miniskirt and leopard print blouse with a neckline below her (probably artificial) boobs. She also had an artificial tan that was so dark, I thought she was black the first time I saw her. It might have been appropriate dress for a Halloween party, but not at work.
What did you find in your research? What gives this drug advantages vs. disadvantages compared to vanco?
i think i have it.
We have it at UMich. If I remember right we used it for a patient with MRSA bacteremia who failed dapto with high MICs for linezolid and vanco. A study reviewed by Attwood and LaPlante in 'Televancin: a novel lipoglycopeptide antimicrobial agent." showed superiority of televancin compared to vanco when treating MRSA bacteremia in neutropenic mice.
And how was Vanco dosed in the study?
telvancin: 40 mg/kg, vanco: 110 mg/kg; both q 12hrs. Not saying I agree that it's superior, just that that's what a particular study (yes, it was done by the manufacturer) found. Read it for yourself and make up your own mind.
I could care less about drugs reps, but your hatred is pathological. Kinda reminds me of Ohio State Fans. They hate Michigan more than they actually like themselves. Sad.
Since you asked about superiority data, I bet my bottom dollar that all you are interested in is the dollar and that when the dollars are not in your masters(administration) favor you don't want to see the superiority data. Right?
What about Ampho B vs. vori? There are multiple RCTs that show survival benefit, clinical superiority, and positive pharmacoeconomic outcomes in favor of vori yet most hospitals in our system still use more ampho for IAI. Why? Money.
Because pharmacists, like everyone else CAN BE BRIBED. It's not overt. It's subtle. We incent our service leaders on cost per unit. Over the course of time, when you can choose a cheap generic vs an expensive branded agent, well in the back of your mind that yearly bonus is bribing you. Every one of us. Thinking that I can stick it to the drug rep makes it even more pleasurable but in the end, just someone else is providing the influence over me.
BTW, on another topic we did our outcomes study on MRSA and gram positive agents and the only place we could find any potential benefit(numbers not big enough to say with confidence)to the branded agents was in obese diabetics renal disasters.
Have a good day and stick it to some drug rep dolt if it makes you feel like you have a big boy. Doesn't make it so, but if you believe it - it is so.
Just like your hatred towards me...which is probably worse than how I hate the reps.. you still upset about the generic zosyn thing eh? Let it go!!
Oh.. where should I start. You have no idea.. have you seen the look of hospital staff getting laid off because of the closure? Money matters.. more importantly, patient care matters. Yet, if there's no money, in the end, the patients suffer.
My issue isn't with expensive drugs. My issue is when drugs are used inappropriately because of the good looking 25 year old female rep came in and brought food for everyone flashed the prescriber. You're too young and too inexperienced to have seen this practice in its hay days.
Really? None of my hospitals use Ampho. liposomal maybe. Your hospital system sucks.
I can't be bribed. That would be a conflict of interest. More importantly, I'm a patient advocate...tho you don't believe that.
u huh... sounds like you've been gettin beat up some!
where are your crickets?
Just like your hatred towards me...which is probably worse than how I hate the reps.. you still upset about the generic zosyn thing eh? Let it go!!
Oh.. where should I start. You have no idea.. have you seen the look of hospital staff getting laid off because of the closure? Money matters.. more importantly, patient care matters. Yet, if there's no money, in the end, the patients suffer.
My issue isn't with expensive drugs. My issue is when drugs are used inappropriately because of the good looking 25 year old female rep came in and brought food for everyone flashed the prescriber. You're too young and too inexperienced to have seen this practice in its hay days.
Really? None of my hospitals use Ampho. liposomal maybe. Your hospital system sucks.
I can't be bribed. That would be a conflict of interest. More importantly, I'm a patient advocate...tho you don't believe that.
u huh... sounds like you've been gettin beat up some!
where are your crickets?
Where the hell have you seen these? All the drug reps that visit us are older and rather ugly.
oh..btw, on my guidelines, Vori is the DOC for IAI. We do recommend IV to PO conversion when appropriate.
So.. sounds like you should vent your anger at your admin.. not me.
Sucks to be you eh?
Agreed. Vori is the DOC according to IDSA...I did residency at a very poor hospital system and we still used vori over ampho. When it is a standard of practice, you can't really get away with the cost savings reasoning.
I still have yet to see anyone running out to put telavancin on formulary.
Our drug reps are bombshells. The last one that rolled through was wearing a revealing blouse. She had nice legs, too 😉
And we rarely use Ampho....only Ambisome is used often and even then it is maybe one or two inpatients and maybe an outpatient. We went through vori like water last month.
And we rarely use Ampho....only Ambisome is used often and even then it is maybe one or two inpatients and maybe an outpatient. We went through vori like water last month.
The drug rep who brought me a Humalog Kwikpen kit to play with today was pretty damn good looking. Although I suppose by some people's standards she might be considered "old" - early to mid 30's maybe??
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Yeah, definitely no Ampho for IAI.
Is your system in Mexico?
I haven't been too impressed with our drug reps lately. A lot of the "one of the guys"-type dudes with beer guts.
Is your system in Mexico?
I haven't been too impressed with our drug reps lately. A lot of the "one of the guys"-type dudes with beer guts.
Not really, if you're just looking at fixed costs. Vancomycin costs a few bucks a gram, and I think a level is around $18. A single dose of televancin is going to be quite a bit more than that. Unless you have a dedicated FTE kinetics pharmacist, it isn't going to save you money. Not even mentioning that vanco has lots of good data for all sorts of infections, and its questionable whether you should use televancin for anything.
Exactly.......
Any reason that they wouldn't have gone to daptomycin instead? Just wondering what the thought process was.
Didn't want to waste VRE coverage
