Daily Medication Pearl: Oritavancin (Orbactiv)

Medication Pearl of the Day: Oritavancin (Orbactiv)

Indication: Oritavancin (Orbactiv) is a lipoglycopeptide antibacterial drug indicated for the treatment of adult patients with acute bacterial skin and skin structure infections caused or suspected to be caused by susceptible isolates of designated Gram-positive microorganisms.


  • Dosing:Administer 1200 mg of oritavancin as a single dose by intravenous infusion over 3 hours.
  • Dosage forms: For injection 400 mg of lyophilized powder in a single-dose vial for reconstitution.
  • Adverse events:The most common adverse reactions (≥3%) in patients treated with oritavancin were headache, nausea, vomiting, limb and subcutaneous abscesses, and diarrhea.
  • Mechanism of action:Oritavancin has 3 mechanisms of action: (1) inhibition of the transglycosylation (polymerization) step of cell wall biosynthesis by binding to the stem peptide of peptidoglycan precursors; (2) inhibition of the transpeptidation (crosslinking) step of cell wall biosynthesis by binding to the peptide bridging segments of the cell wall; and (3) disruption of bacterial membrane integrity, leading to depolarization, permeabilization, and cell death.

Source: orbactiv-prescribing-information.pdf