Comparative Pharmacology
Head-to-head clinical analysis: ORBACTIV versus ZOSYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ORBACTIV versus ZOSYN.
ORBACTIV vs ZOSYN
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.
Piperacillin, a semisynthetic penicillin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). Tazobactam, a beta-lactamase inhibitor, inactivates beta-lactamases, preventing piperacillin degradation.
1200 mg IV once daily for 3 days
3.375 g (piperacillin 3 g / tazobactam 0.375 g) intravenously every 6 hours over 30 minutes; for nosocomial pneumonia, 4.5 g intravenously every 6 hours.
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).
Piperacillin ~0.7-1.2 h; tazobactam ~0.7-1.0 h; extended in renal impairment (piperacillin up to 3.3 h, tazobactam up to 4.7 h in CrCl <20 mL/min)
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 renal; piperacillin 68% unchanged, tazobactam 80% unchanged; biliary/fecal excretion <10%
Category C
Category C
Antibiotic
Antibiotic