Comparative Pharmacology
Head-to-head clinical analysis: ORBACTIV versus SYNERCID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ORBACTIV versus SYNERCID.
ORBACTIV vs SYNERCID
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Oritavancin is a lipoglycopeptide antibiotic that inhibits bacterial cell wall synthesis by binding to the D-alanyl-D-alanine terminus of the peptidoglycan precursor, disrupting transglycosylation and transpeptidation. It also disrupts bacterial membrane integrity and causes depolarization, leading to cell death.
Synercid is a combination of two streptogramin antibiotics, quinupristin and dalfopristin, which bind to the 50S bacterial ribosome and inhibit protein synthesis. Quinupristin binds to the 23S rRNA near the peptidyl transferase center, while dalfopristin binds to a nearby site and enhances quinupristin's binding. The synergistic effect results in irreversible inhibition of bacterial protein synthesis.
1200 mg IV once daily for 3 days
7.5 mg/kg IV every 8 hours, administered as a 60-minute infusion.
None Documented
None Documented
Terminal elimination half-life is approximately 15.1 hours in healthy adults; in patients with renal impairment, half-life is prolonged (up to 28 hours in severe renal impairment).
The terminal elimination half-life is approximately 0.85 hours for dalfopristin and 1.3 hours for quinupristin; however, the active metabolite of quinupristin has a half-life of about 3.5 hours, supporting twice-daily dosing.
Primarily renal excretion as unchanged drug (approximately 33% of administered dose) and via biliary/fecal elimination (~50% recovered in feces as parent drug and metabolites).
Primarily hepatic metabolism with biliary excretion; approximately 15% of the dalfopristin dose and 32% of the quinupristin dose are excreted unchanged in feces; renal excretion is minor (<5% for both components).
Category C
Category C
Antibiotic
Antibiotic