Skip to content
Dr. Grey AI

Peptide

Oritavancin (Orbactiv)

Oritavancin is a second-generation lipoglycopeptide antibiotic for acute bacterial skin infections. FDA-approved August 2014. Single-dose therapy: 1200 mg IV infusion provides complete treatment. SOLO-1 & SOLO-2 Phase 3 (n=1987): Noninferior to 7-10 day vancomycin course (81.2% vs 80.9% composite endpoint). Superior MRSA lesion reduction (93.1% vs 87.1%, P=0.032). Half-life 245 hours enables once-only dosing. Coverage: MRSA, MSSA, Streptococci, E. faecalis. Vancomycin derivative with enhanced lipophilic properties.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
5
Graded outcomes
4010

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Skin and Soft Tissue Infections

Skin and Soft Tissue Infections: outcomes studied for Oritavancin (Orbactiv)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Clinical Cure Rate

SOLO-1 & SOLO-2 pooled (n=1987): Primary composite endpoint 81.2% oritavancin vs 80.9% vancomycin (noninferior). Investigator-assessed clinical cure 81.2% vs 80.2%. Single dose noninferior to 7-10 day vancomycin. NCT01252719, NCT01252732.

NoneNo effect20 studies

Studies that measured clinical cure rate

and 10 more in the citations list

Early Clinical Response

≥20% lesion area reduction at 48-72h: 86.4% oritavancin vs 84.1% vancomycin. Met FDA-required early clinical response endpoint. Enables outpatient treatment with single hospital visit.

NoneNo effect14 studies

Studies that measured early clinical response

and 4 more in the citations list

Safety Profile

Pooled safety (n=1959): Adverse events 55.3% vs 56.9% vancomycin. Serious AEs 5.8% vs 5.9%. Common: nausea, headache, vomiting. Infusion-related reactions ~3%. No renal toxicity advantage over vancomycin in ABSSSI.

NoneNo effect14 studies

Studies that measured safety profile

and 4 more in the citations list

MRSA Efficacy

SOLO trials (n=405 MRSA): ≥20% lesion size reduction 93.1% oritavancin vs 87.1% vancomycin (difference 6.1%, P=0.032). Statistically superior to vancomycin for MRSA infections specifically.

Improves (the measure goes up)Small effect12 studies

Studies that measured mrsa efficacy

and 2 more in the citations list

General

General: outcomes studied for Oritavancin (Orbactiv)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

26 systematic reviews and preclinical studies support this finding. Evidence includes systematic reviews/meta-analyses. Primarily preclinical evidence.

Improves (the measure goes up)Moderate effect19 studies

Studies that measured antimicrobial activity

and 9 more in the citations list

Key findings

  • Clinical Cure RateSkin and Soft Tissue Infections
  • Early Clinical ResponseSkin and Soft Tissue Infections
  • Safety ProfileSkin and Soft Tissue Infections

Safety notes in the studies

  • Pooled safety (n=1959): Adverse events 55.3% vs 56.9% vancomycin.
  • No renal toxicity advantage over vancomycin in ABSSSI.

Studies cited

33 studies from PubMed

  1. Oritavancin a Therapeutic Option for Periprosthetic Joint Infections in Selected Cases: A Comprehensive Review.Pharmaceuticals (Basel, Switzerland), 2025 · PMID 40872608
  2. A Comparative Review of the Pharmacology of Dalbavancin and Oritavancin for Gram-Positive Infections: Birds of a Feather or Apples and Oranges?Infectious diseases and therapy, 2025 · PMID 40903703
  3. Oritavancin for Treatment of Osteomyelitis: A Systematic Review and Meta-Analysis of Observational Studies.Pharmacotherapy, 2025 · PMID 41224240
  4. Experience with expanded use of oritavancin in a tertiary hospital: indications, tolerability and outcomes.JAC-antimicrobial resistance, 2024 · PMID 39493938
  5. Role of Oritavancin in the Treatment of Infective Endocarditis, Catheter- or Device-Related Infections, Bloodstream Infections, and Bone and Prosthetic Joint Infections in Humans: Narrative Review and Possible Developments.Life (Basel, Switzerland), 2023 · PMID 37109488
  6. The Clinical Efficacy of Multidose Oritavancin: A Systematic Review.Antibiotics (Basel, Switzerland), 2023 · PMID 37887199
  7. The role of long-acting antibiotics in the clinical practice: a narrative review.Le infezioni in medicina, 2023 · PMID 38075413
  8. Kimyrsa, An Oritavancin-Containing Product: Clinical Study and Review of Properties.Open forum infectious diseases, 2022 · PMID 35392455
  9. Efficacy and safety of oritavancin for the treatment of acute bacterial skin and skin-structure infections: a systematic review and meta-analysis.Journal of global antimicrobial resistance, 2021 · PMID 33989846
  10. Glycopeptide Hypersensitivity and Adverse Reactions.Pharmacy (Basel, Switzerland), 2020 · PMID 32326261
  11. Treatment of osteoarticular, cardiovascular, intravascular-catheter-related and other complicated infections with dalbavancin and oritavancin: A systematic review.International journal of antimicrobial agents, 2020 · PMID 32603683
  12. Treatment of chronic osteomyelitis with multidose oritavancin: A case series and literature review.International journal of antimicrobial agents, 2019 · PMID 30537532
  13. Antibiotic penetration into bone and joints: An updated review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2019 · PMID 30772469
  14. Oritavancin (Orbactiv): a new-generation lipoglycopeptide for the treatment of acute bacterial skin and skin structure infectionsP T, 2018 · PMID 29491695
  15. Single intravenous dose of oritavancin for treatment of acute skin and skin structure infections caused by gram-positive bacteria: summary of safety analysis from the phase 3 SOLO studiesAntimicrob Agents Chemother, 2018 · PMID 29576495
  16. A real-world patient registry for oritavancin demonstrates efficacy and safety consistent with the phase 3 SOLO programOpen Forum Infect Dis, 2018 · PMID 29868820
  17. Developments in Glycopeptide Antibiotics.ACS infectious diseases, 2018 · PMID 29363950
  18. Review of oritavancin for the treatment of acute bacterial skin and skin structure infections.Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria, 2018 · PMID 29501059
  19. Efficacy and safety of oritavancin relative to vancomycin for patients with acute bacterial skin and skin structure infections (ABSSSI) in the outpatient setting: results from the SOLO clinical trialsOpen Forum Infect Dis, 2017 · PMID 28480266
  20. Oritavancin: a novel lipoglycopeptideAnn Pharmacother, 2016 · PMID 26842686
  21. Oritavancin: A New Lipoglycopeptide Antibiotic in the Treatment of Gram-Positive Infections.Infectious diseases and therapy, 2016 · PMID 26831328
  22. Single-dose oritavancin versus 7-10 days of vancomycin in the treatment of gram-positive acute bacterial skin and skin structure infections: the SOLO II noninferiority studyClin Infect Dis, 2015 · PMID 25294250
  23. Oritavancin: a review in acute bacterial skin and skin structure infectionsDrugs, 2015 · PMID 26464319
  24. Oritavancin for the treatment of acute bacterial skin and skin structure infections: an evidence-based review.Core evidence, 2015 · PMID 25709561
  25. Single-dose oritavancin in the treatment of acute bacterial skin infectionsN Engl J Med, 2014 · PMID 24897083
  26. Renaissance of antibiotics against difficult infections: Focus on oritavancin and new ketolides and quinolones.Annals of medicine, 2014 · PMID 25058176
  27. Glycopeptide antibiotics: back to the future.The Journal of antibiotics, 2014 · PMID 25118105
  28. Oritavancin: an investigational lipoglycopeptide antibiotic.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2013 · PMID 23261897
  29. Oritavancin, a new lipoglycopeptide antibiotic: results from a thorough QT study.Journal of clinical pharmacology, 2010 · PMID 20484618
  30. New lipoglycopeptides: a comparative review of dalbavancin, oritavancin and telavancin.Drugs, 2010 · PMID 20426497
  31. Oritavancin--an investigational glycopeptide antibiotic.Expert opinion on investigational drugs, 2006 · PMID 16548791
  32. Oritavancin and tigecycline: investigational antimicrobials for multidrug-resistant bacteria.Pharmacotherapy, 2004 · PMID 14740788
  33. Mechanism of action of oritavancin and related glycopeptide antibiotics.FEMS microbiology reviews, 2003 · PMID 12586393