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Volume 18
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10.3390/pharmaceutics18050628
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Article

Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study

by
Ana Alarcia-Lacalle
1,
Miguel Ángel Morán-Rodríguez
2,3,
Laura Morata
4,
Arantxa Isla
1,3,
Andrés Canut-Blasco
3,5 and
Alicia Rodríguez-Gascón
1,3,*
1
Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Centre, University of the Basque Country EHU, Paseo de la Universidad n° 7, 01006 Vitoria-Gasteiz, Spain
2
Infectious Disease Division, Araba University Hospital, Osakidetza Basque Health Service, Francisco Leandro de Viana Kalea, 01009 Vitoria-Gasteiz, Spain
3
Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy, Bioaraba Health Research Institute, Jose Atxotegi Kalea s/n, 01009 Vitoria-Gasteiz, Spain
4
Department of Infectious Diseases, Hospital Clínic of Barcelona, University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain
5
Microbiology Service, Araba University Hospital, Osakidetza Basque Health Service, Francisco Leandro de Viana Kalea, 01009 Vitoria-Gasteiz, Spain
*
Author to whom correspondence should be addressed.
Pharmaceutics 2026, 18(5), 628; https://doi.org/10.3390/pharmaceutics18050628
Submission received: 28 April 2026 / Revised: 16 May 2026 / Accepted: 18 May 2026 / Published: 20 May 2026
(This article belongs to the Special Issue Clinical Pharmacokinetics and Pharmacodynamics of Antimicrobial Therapy)
Versions Notes

Abstract

Background/Objectives: Oritavancin therapy for complex infections remains challenging due to the lack of well-established dosing regimens. The objective of this work was to apply PK/PD modeling and Monte Carlo simulation considering different PK/PD targets to identify multiple-dosing regimens that may ensure effective concentrations of oritavancin for the treatment of long-term infections. Methods: Plasma concentration–time profiles were simulated for different regimens (single dose of 1200 mg, 1200 mg followed by 800 mg every 7 days (q7d), 1200 mg followed by 800 mg q10d, 1200 mg q7d, 1200 mg q10d, 1200 mg q14d, 1200 mg q21d, and 1200 mg followed by 1200 mg on day 8, then 1200 mg q14d), and the probability of target attainment (PTA), indicative of treatment success, was estimated. Results: All dosing regimens provided probabilities of target attainment of 100% up to MICs of 0.5 mg/L when AUC0–24/MIC and Cmax/MIC were applied. Considering AUC0–72/MIC, the regimens would be adequate up to an MIC of 0.125 mg/L. For fCmin > MIC, all except 1200 mg q21d were adequate for an MIC of 0.125 mg/L, and 1200 mg day 1 + 800 mg q7d and 1200 mg q10d may be useful to treat infections due to bacteria with an MIC of 0.25 mg/L. Conclusions: More studies involving patients with complex infections are needed to better stablish the relationships among plasma concentrations, MIC values, and clinical outcomes. fCmin > MIC should be investigated as a potential PK/PD target for the treatment of these infections with oritavancin.
Keywords: oritavancin; complex infection; PK/PD; fCmin > MIC; AUC/MIC; Monte Carlo simulation oritavancin; complex infection; PK/PD; fCmin >; MIC; AUC/MIC; Monte Carlo simulation

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MDPI and ACS Style

Alarcia-Lacalle, A.; Morán-Rodríguez, M.Á.; Morata, L.; Isla, A.; Canut-Blasco, A.; Rodríguez-Gascón, A. Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study. Pharmaceutics 2026, 18, 628. https://doi.org/10.3390/pharmaceutics18050628

AMA Style

Alarcia-Lacalle A, Morán-Rodríguez MÁ, Morata L, Isla A, Canut-Blasco A, Rodríguez-Gascón A. Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study. Pharmaceutics. 2026; 18(5):628. https://doi.org/10.3390/pharmaceutics18050628

Chicago/Turabian Style

Alarcia-Lacalle, Ana, Miguel Ángel Morán-Rodríguez, Laura Morata, Arantxa Isla, Andrés Canut-Blasco, and Alicia Rodríguez-Gascón. 2026. "Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study" Pharmaceutics 18, no. 5: 628. https://doi.org/10.3390/pharmaceutics18050628

APA Style

Alarcia-Lacalle, A., Morán-Rodríguez, M. Á., Morata, L., Isla, A., Canut-Blasco, A., & Rodríguez-Gascón, A. (2026). Oritavancin Multiple Dosing for Complex Infections: A Pharmacokinetic/Pharmacodynamic Simulation Study. Pharmaceutics, 18(5), 628. https://doi.org/10.3390/pharmaceutics18050628

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