{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:38:39Z","timestamp":1783996719431,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteomyelitis (OM) is a complex inflammatory bone infection typically requiring prolonged antibiotic therapy. Oritavancin (ORI), a long\u2010acting lipoglycopeptide with activity against biofilm\u2010embedded pathogens, has emerged as a potential treatment option despite previous US Food and Drug Administration (FDA) warnings against its use in OM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis of observational studies in seven databases through August 8, 2024 (PROSPERO registration: CRD42025635473) to evaluate the available evidence on ORI's efficacy and safety in OM. Clinical success was defined as the improvement or resolution of infection without requiring additional gram\u2010positive antibiotics, surgical debridement, or amputation. Study quality was assessed using the Newcastle\u2013Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our systematic review included nine observational studies comprising 316 patients with OM treated with ORI. Quality assessment using the Newcastle\u2010Ottawa Scale revealed scores ranging from 5\/9 to 8\/9, with most studies demonstrating adequate outcome assessment but limitations in cohort selection and comparability. Meta\u2010analysis demonstrated a pooled clinical success rate of 81% (95% CI: 76%\u201385%). Comparative analysis of two studies yielded an odds ratio of 2.99 (95% CI: 0.86\u201310.36) favoring ORI over comparators (daptomycin and dalbavancin), though with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200980.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0247).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite previous warnings, we found no evidence of ineffectiveness with ORI for OM. ORI's infrequent dosing schedule may provide convenience over daily parenteral therapy, particularly for difficult\u2010to\u2010treat pathogens like MRSA and VRE. Further research is needed to optimize dosing strategies based on pathogen susceptibility and establish appropriate therapeutic drug monitoring protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70072","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T01:00:55Z","timestamp":1762995655000},"page":"754-763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Oritavancin for Treatment of Osteomyelitis: A Systematic Review and Meta\u2010Analysis of Observational Studies"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-7462","authenticated-orcid":false,"given":"Martin","family":"Krsak","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases University of Colorado School of Medicine  Aurora Colorado 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A.","family":"Grimshaw","sequence":"additional","affiliation":[{"name":"Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-0195","authenticated-orcid":false,"given":"Daniel","family":"Chastain","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy University of Georgia College of Pharmacy  Albany Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Steuber","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Practice and Administration University of Missouri \u2013 Kansas City at MU School of Pharmacy  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Sah","sequence":"additional","affiliation":[{"name":"Department of Medicine St. Elizabeth's Medical Center, BMC Health System  Massachusetts 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