Infectious Disease Compendium

Lefamulin (Xenleta)

Dosing

CrCl Formula

CrCl > 80:

150 mg intravenously every 12 hours

600mg BID po

CrCl 80-50:

CrCl 50-10:

CrCl < 10:

Hemodialysis:

Peritoneal dialysis:

Important side effects

Prolongation of QT interval.

Important drug interactions

Rants and Screeds

Pearls

Don't use in liver failure.

As of 2019, $200 + a day.

Treatment of choice

Use for

Community-acquired Bacterial Pneumonia, where it is no worse than moxifloxicin (Pubmed).

Gram-positives: Streptococcus pneumoniae, Staphylococcus aureus [including MRSA], Enterococcus faecium [including VRE], coagulase negative staphylococci, beta-hemolytic streptococci, viridans group streptococci. Gram-negatives: Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis. Atypicals: Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae, Mycoplasma genitalium.

Don't use for

Class

Pleuromutilin antibiotic. Inhibits bacterial protein synthesis by binding to the peptidyl transferase of the 50S bacterial ribosome, to prevent the binding of transfer RNA for peptide transfer.

Last Update: 10/16/19.