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Background: Telavancin is approved in the USA and Europe (methicillin-resistant [MRSA] only) for the treatment of hospital-acquired (HABP) and ventilator-associated bacterial pneumonia (VABP) caused by S. aureus when alternative treatments are not suitable. This study provides a current in vitro activity analysis for telavancin and comparators against S. aureus causing HABP in USA hospitals during 2013 – 2014. Methods: 1,353 S. aureus collected from 29 USA sites located in the nine USA Census regions were included. Susceptibility testing was performed based on CLSI guidelines (M07-A10 and M100-S25). MIC interpretation was guided by FDA (2014), CLSI (2015) and/or EUCAST (2015) criteria. MRSA resistant to three or more drug classes were defined as multidrugresistant (MDR). Results: Telavancin had MIC50, MIC90 and MIC100 of 0.03, 0.06 and 0.06 mg/mL, respectively, against methicillin-susceptible, MRSA, non-MDR and MDR subsets. All isolates were inhibited by telavancin at the susceptible breakpoint (i.e. ≤0.12 mg/mL). Telavancin MIC values were at least 16-fold lower than vancomycin (MIC50/90, 1/1 μg/mL) and linezolid (MIC50/90, 1/1 μg/mL) MIC results against MRSA isolates (all 100.0% susceptible to vancomycin and linezolid). Telavancin, vancomycin (MIC50/90, 1/1 μg/mL) and linezolid (MIC50/90, 1/1 μg/mL) showed activity against the MDR subset, while other agents had limited coverage. S. aureus with vancomycin MIC=2 μg/mL had telavancin MIC50 (0.06 μg/mL) twofold higher than those with vancomycin MIC at ≤1 μg/mL. However, telavancin had MIC100 results of 0.06 μg/mL, regardless of subset. Conclusions: Telavancin had potent in vitro activity against S. aureus causing HABP, including less susceptible and MDR subsets, inhibiting all S. aureus at ≤0.06 μg/mL. These results confirm the potent in vitro activity of telavancin against S. aureus causing HABP in USA hospitals. CONCLUSIONS • Telavancin had potent in vitro activity against S. aureus causing HABP among hospitalized patients in USA institutions, including isolates less susceptible to vancomycin and MDR subsets. • All S. aureus were inhibited by telavancin at ≤0.06 μg/mL and telavancin was consistently more potent than comparator agents. These in vitro results support the use of telavancin for the treatment of HABP caused by S. aureus in USA hospitals.

open forum infectious diseases

Analysis of Telavancin In Vitro Activity Tested Against a USA Collection of Staphylococcus aureus Clinical Isolates Causing Hospital-Acquired Pneumonia (2013–2014)