Efficacy of telavancin in patients with specific types of complicated skin and skin structure infections

Telavancin is approved in the USA and Canada for the treatment of Gram-positive complicated skin and skin structure infections (cSSSIs) based on the results of the Phase 3 Assessment of TeLAvancin in complicated Skin and skin structure infections (ATLAS) trials, which demonstrated non-inferiority of telavancin to vancomycin. We conducted a post hoc analysis of the ATLAS studies (ClinicalTrials.gov identifiers NCT00091819 and NCT00107978) to explore the efficacy of telavancin in patients with various types of cSSSIs. A total of 1794 patients were included in this analysis; 1434 patients were clinically evaluable (CE) and 563 of these had methicillin-resistant Staphylococcus aureus (MRSA). Among CE patients with major abscesses (n619), cure rates were 91 for telavancin and 90 for vancomycin (95 CI for the difference 3.6 to 5.7). In patients with infective cellulitis (n519), cure was achieved in 87 and 88 of telavancin- and vancomycin-treated patients, respectively (95 CI for the difference 6.2 to 5.2). Cure rates in patients with wound infections were 85 in the telavancin group and 86 in the vancomycin group (95 CI for the difference 10.5 to 9.0). Cure rates for each type of cSSSI in patients infected with MRSA were also similar between the two treatment arms. Among CE patients infected with PantonValentine leucocidin (PVL)-positive MRSA (n447), cure rates were 93 for telavancin and 90 for vancomycin (95 CI for the difference 2.2 to 8.2). Cure rates were similar for telavancin and vancomycin in patients with different types of cSSSIs, including infections caused by MRSA and PVL-positive strains of MRSA.