Orbactiv (Oritavancin)
Single-dose lipoglycopeptide antibiotic for acute bacterial skin and skin structure infections
Quick Facts About Orbactiv
Key Takeaways About Orbactiv
- Single-dose regimen: One 1200 mg intravenous infusion over three hours delivers a complete course of antibiotic therapy, eliminating the need for multi-day intravenous access.
- Broad Gram-positive coverage: Active against MRSA, methicillin-susceptible S. aureus, group A and B streptococci, the S. anginosus group, and vancomycin-susceptible Enterococcus faecalis.
- Very long half-life: A terminal elimination half-life of approximately 245 hours (around 10 days) enables sustained bactericidal concentrations from a single dose.
- Heparin alert: Oritavancin artificially prolongs aPTT for up to 120 hours; intravenous unfractionated heparin monitored by aPTT is contraindicated during this window.
- Hospital-administered: Orbactiv must be reconstituted, diluted and given under direct medical supervision because of the risk of infusion reactions and the need for trained preparation.
What Is Orbactiv and What Is It Used For?
Orbactiv (oritavancin) is a semi-synthetic lipoglycopeptide antibiotic used to treat acute bacterial skin and skin structure infections (ABSSSI) in adults. It is given as a single intravenous infusion and is active against difficult-to-treat Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA).
Orbactiv belongs to the lipoglycopeptide class of antibiotics, a small but clinically important group that also includes vancomycin, telavancin and dalbavancin. The active substance, oritavancin, is a chemically modified derivative of the naturally occurring glycopeptide chloroeremomycin. The modifications give oritavancin enhanced activity against resistant Gram-positive pathogens and a uniquely long terminal half-life that allows an entire treatment course to be delivered in a single infusion.
Orbactiv is licensed by the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) for the treatment of acute bacterial skin and skin structure infections in adult patients. In clinical practice, ABSSSI includes major cutaneous abscesses, cellulitis, erysipelas and wound infections in which at least 75 cm2 of skin is involved, or where there is associated lymphadenopathy or systemic signs such as fever, elevated white blood cell count or elevated C-reactive protein.
The clinical rationale for developing a long-acting lipoglycopeptide is clear. Traditional treatment for severe skin infections, especially when MRSA is suspected, has historically required prolonged intravenous courses of vancomycin, often delivered in hospital or through home infusion services. Orbactiv addresses the logistical burden of such regimens by concentrating the full therapeutic exposure into a single, controlled infusion, potentially reducing hospital length of stay, readmission risk and the complications associated with long-term central venous access.
How Orbactiv Works
Oritavancin has a multimodal bactericidal mechanism that distinguishes it from older glycopeptides. It binds with high affinity to the D-alanyl-D-alanine terminus of peptidoglycan precursors, blocking the transglycosylation (polymerization) step of bacterial cell wall synthesis. In addition, structural features derived from its hydrophobic side chain enable it to inhibit transpeptidation (cross-linking) and to disrupt the integrity of the bacterial cell membrane.
This triple mechanism produces rapid, concentration-dependent killing of Gram-positive bacteria and helps to explain activity against vancomycin-resistant organisms where only a single mechanism would fail. Oritavancin demonstrates potent in vitro activity against methicillin-susceptible and methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus agalactiae, the Streptococcus anginosus group and vancomycin-susceptible Enterococcus faecalis. It also retains activity against heterogeneously vancomycin-intermediate and daptomycin-non-susceptible S. aureus strains in susceptibility testing.
The pharmacokinetics of oritavancin are unusual among antibiotics. After a 1200 mg infusion, total systemic exposure (AUC0–72h) is approximately 1110 µg·h/mL, with a terminal elimination half-life of around 245 hours. The drug distributes extensively into skin and skin structures, maintaining bactericidal concentrations for many days. Oritavancin is not metabolized by hepatic enzymes to a clinically relevant degree and is slowly excreted unchanged in urine and feces.
The pivotal SOLO I and SOLO II trials, published in the New England Journal of Medicine, showed that a single 1200 mg dose of oritavancin was non-inferior to 7–10 days of twice-daily intravenous vancomycin for ABSSSI. Both trials enrolled adults with documented or suspected Gram-positive skin infections, and MRSA was isolated in approximately 20% of participants.
What Should You Know Before Taking Orbactiv?
Before receiving Orbactiv, tell your prescriber about any previous allergic reactions to glycopeptide antibiotics, any bleeding or clotting disorders, any planned need for intravenous heparin, and any history of Clostridioides difficile-associated diarrhea. Orbactiv is contraindicated if you are hypersensitive to oritavancin or will need aPTT-monitored intravenous unfractionated heparin in the next five days.
Because Orbactiv delivers a complete course of antibiotic in a single infusion, the opportunity to stop treatment early or adjust dosing in response to an adverse event is far more limited than with conventional multi-dose antibiotics. This makes a careful pre-infusion risk assessment particularly important. The prescribing team should confirm the indication, review allergy history, screen for drug interactions and check kidney and liver function where clinically relevant.
Contraindications
Orbactiv must not be administered in the following circumstances:
- Hypersensitivity to oritavancin or to any of the excipients in the formulation (mannitol, phosphoric acid, sodium hydroxide).
- Planned use of intravenous unfractionated heparin sodium within 120 hours (5 days) after the oritavancin dose, because oritavancin artificially prolongs activated partial thromboplastin time (aPTT) and makes heparin monitoring unreliable.
A previous hypersensitivity reaction to other glycopeptides, such as vancomycin or telavancin, is not an absolute contraindication, but cross-reactivity is possible and treatment should only proceed with close monitoring and an alternative option immediately available.
Warnings and Precautions
Talk to your doctor before receiving Orbactiv if any of the following apply:
- Hypersensitivity reactions: Serious reactions, including anaphylaxis, have been reported. If breathlessness, swelling of the face or throat, severe rash or collapse occur, the infusion must be stopped immediately.
- Infusion-related reactions: Symptoms resembling "red man syndrome" (flushing of the upper body, urticaria, pruritus or rash) may develop during infusion. Slowing or briefly interrupting the infusion usually resolves these.
- Osteomyelitis: In the pivotal trials, more cases of osteomyelitis were reported in the oritavancin group than in the comparator group. Patients who develop new or worsening bone pain after infusion should be evaluated and treated with alternative antibiotics as appropriate.
- Clostridioides difficile-associated diarrhea: Like virtually all antibiotics, oritavancin can disturb normal gut flora and has been associated with both mild diarrhea and pseudomembranous colitis.
- Coagulation test interference: Oritavancin non-specifically binds to and prevents the action of the phospholipid reagents used in common coagulation tests, artificially prolonging aPTT (up to 120 hours), prothrombin time (PT) and INR (up to 12 hours), and activated clotting time (ACT) (up to 24 hours).
- Severe hepatic impairment: Orbactiv has not been studied in patients with Child-Pugh class C liver disease and should be used with caution.
- Concomitant warfarin therapy: Because oritavancin is a weak CYP2C9 inhibitor in vitro and can interfere with INR measurement, warfarin management requires extra care.
Intravenous unfractionated heparin sodium monitored by aPTT is contraindicated for 120 hours (5 days) after oritavancin. Non-aPTT-monitored alternatives such as low-molecular-weight heparin, direct oral anticoagulants or factor Xa inhibitors may be used when anticoagulation is clinically necessary. If aPTT must be measured within five days of dosing, the result should be interpreted with extreme caution or confirmed using a chromogenic assay.
Pregnancy and Breastfeeding
There are no adequate and well-controlled clinical studies of oritavancin in pregnant women. Animal reproduction studies have not shown direct embryo-fetal harm at clinically relevant exposures, but the long half-life means that drug-related residues persist in the maternal circulation for many weeks after a single dose. Orbactiv should therefore only be used during pregnancy if the expected benefit clearly outweighs the potential risk, and alternative antibiotics with more extensive safety data should be considered when appropriate.
It is unknown whether oritavancin or its metabolites are excreted in human milk. In animal studies, oritavancin-related material was detected in the milk of lactating rats. A risk to the breastfed infant cannot be excluded, so a decision must be made whether to discontinue breastfeeding or to avoid oritavancin, taking into account the benefit of treatment for the mother and the importance of breastfeeding for the child.
Children and Older Adults
Safety and efficacy in patients under 18 years of age have not been established. No dose adjustment is required in elderly patients solely on the basis of age, although frail older patients may be more susceptible to infusion-related events and concomitant interacting medications and should be observed carefully during and after administration.
Driving, Machinery and Alcohol
Orbactiv is not expected to have a clinically significant effect on the ability to drive or operate machinery once the infusion is complete and any acute infusion-related symptoms have resolved. No specific alcohol interaction has been identified, but alcohol should be avoided during any acute infection requiring hospital treatment.
How Does Orbactiv Interact with Other Drugs?
The most clinically important interaction of Orbactiv is its effect on coagulation tests, particularly aPTT, which is relevant when patients need intravenous unfractionated heparin. Oritavancin is also a weak, non-specific inhibitor of several CYP enzymes, so medicines with a narrow therapeutic index (especially warfarin) may require closer monitoring.
Unlike many newer antibiotics, oritavancin is not a clinically significant substrate of hepatic CYP enzymes and it has no meaningful effect on P-glycoprotein or most common transporter proteins. This means that the list of drug-drug interactions is short but includes some that require specific clinical attention. Because Orbactiv remains in the circulation for many days, these interactions must be considered for several weeks after administration, not just during or immediately after the infusion.
Major Interactions
| Interacting Drug / Class | Effect | Clinical Management |
|---|---|---|
| Intravenous unfractionated heparin (sodium) | Oritavancin artificially prolongs aPTT for up to 120 hours, making heparin monitoring unreliable. | Contraindicated for 120 hours after Orbactiv. Use low-molecular-weight heparin, fondaparinux or DOAC alternatives where anticoagulation is required. |
| Warfarin (CYP2C9 substrate) | Oritavancin is a weak non-specific CYP2C9 inhibitor and transiently prolongs PT/INR for up to 12 hours after infusion. | Monitor INR more frequently for at least 3 days; distinguish laboratory artefact (first 12 hours) from true pharmacodynamic interaction. |
| Other CYP2C9 and CYP2C19 substrates | Potential increased exposure of narrow therapeutic index substrates (e.g. phenytoin, glipizide, voriconazole). | Monitor clinically and by drug concentrations where available for at least 3 days after dosing. |
| CYP3A4 and CYP2D6 substrates | In vitro, oritavancin is a weak inducer; clinically relevant decreases in exposure are unlikely but possible. | Monitor for reduced efficacy of drugs with a narrow therapeutic range during the week following infusion. |
Minor Interactions
| Interacting Drug / Class | Effect | Clinical Management |
|---|---|---|
| Other nephrotoxic agents (e.g. aminoglycosides, amphotericin B) | Additive renal risk is theoretical; oritavancin itself is not primarily nephrotoxic. | Monitor renal function in patients receiving multiple nephrotoxic drugs. |
| Oral anticoagulants measured by INR | INR values measured within 12 hours of infusion may be falsely elevated. | Repeat INR after 12 hours before adjusting the anticoagulant dose. |
| Other glycopeptide antibiotics (vancomycin, telavancin, dalbavancin) | Overlap in mechanism and adverse-event profile; no additional clinical benefit from combination. | Do not co-administer; allow adequate washout if switching antibiotic class. |
| Alcohol | No direct pharmacokinetic interaction identified. | General advice to avoid alcohol during acute infection. |
Patients should share a complete list of their medicines with the prescribing team, including prescription drugs, over-the-counter remedies, herbal products and dietary supplements. Because oritavancin persists in the body for weeks, any new medicine started within 10–14 days of an Orbactiv infusion should be reviewed with this in mind.
What Is the Correct Dosage of Orbactiv?
The approved adult dose of Orbactiv is a single 1200 mg intravenous infusion given over three hours. No additional or follow-up doses are required. Renal or mild-to-moderate hepatic impairment does not require dose adjustment, and Orbactiv is not approved for use in children.
Dosing of Orbactiv is deliberately simple: a single fixed dose of 1200 mg delivered as a three-hour intravenous infusion. Each 1200 mg course requires three 400 mg vials. The powder is first reconstituted with sterile water for injection and then diluted in a 1000 mL bag of 5% dextrose in water (D5W) for infusion. Other intravenous fluids are not compatible with oritavancin; in particular, 0.9% sodium chloride (normal saline) must not be used because of the risk of precipitation.
The drug product does not contain preservatives, and the fully diluted infusion should ideally be administered promptly. If immediate use is not possible, the diluted solution may be stored at 2–8°C for up to 12 hours, but in-use chemical and physical stability has been demonstrated under strictly defined conditions. Infusion sets should be flushed with D5W before and after the oritavancin infusion to prevent incompatibility.
| Patient Group | Dose | Notes |
|---|---|---|
| Adults (18 years and older), normal renal and hepatic function | 1200 mg as a single IV infusion over 3 hours | Complete treatment course; no further doses required. |
| Mild to moderate renal impairment (eGFR >30 mL/min/1.73 m2) | 1200 mg as a single IV infusion over 3 hours | No dose adjustment required. |
| Severe renal impairment or end-stage renal disease | Data limited | Use with caution; oritavancin is not removed by haemodialysis. |
| Mild to moderate hepatic impairment (Child-Pugh A or B) | 1200 mg as a single IV infusion over 3 hours | No dose adjustment required. |
| Severe hepatic impairment (Child-Pugh C) | Not studied | Use only if benefit outweighs risk; close monitoring recommended. |
| Elderly (≥65 years) | 1200 mg as a single IV infusion over 3 hours | No age-based dose adjustment; monitor closely for infusion reactions and comorbid medications. |
| Children and adolescents (<18 years) | Not approved | Safety and efficacy not established. |
Adults
Standard adult dose
1200 mg as a single intravenous infusion administered over three hours. The infusion must be given through a dedicated line using 5% dextrose in water; lines should be flushed with D5W before and after administration if multiple drugs share the same access.
Children
Paediatric use
Orbactiv is not licensed for patients under 18 years of age. No dosing recommendations can be made because paediatric pharmacokinetic and safety data are insufficient. Alternative antibiotics with paediatric indications should be selected.
Elderly
Patients aged 65 and older
The standard 1200 mg dose is used without adjustment. However, elderly patients more often have reduced renal function, polypharmacy and concomitant anticoagulant therapy, so careful review of the medication list and baseline coagulation status is recommended. Post-infusion observation should cover the full three-hour infusion and an additional observation period for delayed hypersensitivity.
Missed Dose
Single-dose regimen
Because Orbactiv is given as a one-off dose during a supervised infusion, a "missed dose" is not applicable in the same way as with oral or repeated intravenous antibiotics. If the planned infusion is postponed or not completed, the clinical team should decide whether to repeat preparation or switch to an alternative antibiotic, taking into account how much of the 1200 mg dose was actually delivered.
Overdose
Management of overdose
Overdose has not been widely reported in clinical practice. In the event of overdose, treatment is supportive. Oritavancin cannot be effectively removed by haemodialysis. Monitoring should focus on signs of infusion-related reactions, hypersensitivity and potential hepatic or renal laboratory abnormalities. There is no specific antidote.
What Are the Side Effects of Orbactiv?
The most common side effects reported with Orbactiv in the SOLO clinical trials were headache, nausea, vomiting, subcutaneous abscess and diarrhea. Most are mild to moderate and self-limiting. Serious but uncommon events include hypersensitivity reactions, infusion-related reactions and osteomyelitis. Because the drug remains active for many days, new symptoms occurring up to two weeks after the infusion should still be reported.
The side-effect profile of Orbactiv was characterized primarily in the pivotal SOLO I and SOLO II randomized trials, which together enrolled more than 1950 adults with acute bacterial skin and skin structure infections. The overall incidence of adverse events was comparable to vancomycin, but the specific pattern differs because Orbactiv is given as a single infusion rather than repeated doses. Frequencies below use the EMA standard: very common (≥1/10), common (1/100 to <1/10), uncommon (1/1000 to <1/100) and rare (<1/1000).
Very Common
- Headache
- Nausea
Common
- Vomiting
- Diarrhea
- Constipation
- Dizziness
- Skin rash, pruritus, urticaria (including infusion-related)
- Limb or subcutaneous abscess (new or worsening)
- Cellulitis
- Tachycardia
- Increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
- Increased serum uric acid
- Musculoskeletal pain
Uncommon
- Hypersensitivity reactions including angioedema
- Infusion-related reactions resembling "red man syndrome" (flushing, chest discomfort, dyspnea)
- Hyperuricemia
- Osteomyelitis
- Clostridioides difficile-associated colitis
- Bronchospasm or wheezing
- Bilirubin increase
- Pyrexia
Rare
- Anaphylaxis
- Severe cutaneous adverse reactions
- Prolonged coagulation test interference leading to clinical misinterpretation
- Deep-seated Gram-positive infections despite treatment
Infusion-related reactions are one of the most characteristic adverse events. They typically occur during or shortly after the start of the infusion and present as upper-body flushing, rash, urticaria or a sense of warmth. Slowing the infusion rate or pausing it temporarily usually allows the symptoms to resolve, after which the infusion can often be completed at a reduced rate under close observation.
Osteomyelitis deserves particular attention. In the SOLO trials, a numerical excess of osteomyelitis cases was seen in the oritavancin arms. It is not entirely clear whether this represents treatment failure, unmasking of pre-existing deep infection, or reporting bias. In practice, patients who develop new bone pain, localized tenderness or persistent systemic signs after Orbactiv should be carefully assessed, including imaging and culture where appropriate, and may require an alternative antibiotic regimen.
Patients should contact their healthcare team urgently if they develop severe rash, facial swelling, shortness of breath, new severe bone pain, severe or bloody diarrhea, jaundice, or any symptoms suggesting a new infection in the two weeks after receiving Orbactiv. These can indicate hypersensitivity, osteomyelitis, C. difficile colitis or treatment failure.
How Should You Store Orbactiv?
Orbactiv is supplied as a sterile powder in a single-use vial and is stored by the hospital pharmacy. Unopened vials are kept at 2–8°C (refrigerator) and must not be frozen. After reconstitution and dilution in 5% dextrose, the infusion should ideally be administered immediately, with limited storage under controlled conditions.
Because Orbactiv is only used in hospitals and specialist infusion services, patients themselves do not store it. However, understanding how the drug is handled can help patients and caregivers appreciate why the infusion must be scheduled in advance and why delays sometimes occur.
Unopened 400 mg vials of Orbactiv are stored in a refrigerator at 2–8°C and protected from light. The vials must not be frozen. Each single-dose vial contains sterile, preservative-free lyophilized powder that is reconstituted with sterile water for injection to form a concentrated solution, then further diluted into 1000 mL of 5% dextrose in water before administration.
Once reconstituted, the concentrate should be used promptly. Once fully diluted in the infusion bag, the chemical and physical in-use stability has been demonstrated for up to 12 hours at 2–8°C and up to 6 hours at 25°C, provided preparation occurred under controlled and validated aseptic conditions. From a microbiological point of view, the infusion is ideally used immediately, and times beyond those specified should only be accepted when preparation has taken place in controlled and validated aseptic conditions.
As with all prescription medicines, Orbactiv must not be used after the expiry date printed on the vial, and any unused infusion must be disposed of in accordance with local pharmaceutical waste regulations. Medicines should never be discarded into wastewater or household refuse.
What Does Orbactiv Contain?
Each Orbactiv vial contains 400 mg of oritavancin (as diphosphate) as the active substance, together with a small number of inactive ingredients (mannitol, phosphoric acid and, where needed, sodium hydroxide for pH adjustment). The product does not contain preservatives.
Understanding what is in a medicine is important, especially for people with allergies or who follow specific dietary restrictions. Orbactiv is formulated as a simple lyophilized powder intended to dissolve cleanly when reconstituted with sterile water for injection.
Active Substance
- Oritavancin diphosphate, equivalent to 400 mg of oritavancin free base per vial.
Excipients (Inactive Ingredients)
- Mannitol – a bulking and stabilizing agent commonly used in lyophilized formulations.
- Phosphoric acid – used for pH adjustment.
- Sodium hydroxide – used, where needed, for pH adjustment.
Orbactiv does not contain lactose, gluten or animal-derived excipients in the final formulation. It is supplied in clear glass vials with a rubber stopper and aluminum over-seal, and the solvent and diluent used for administration (sterile water for injection and 5% dextrose) are supplied separately by the hospital pharmacy.
Appearance and Pack Sizes
Orbactiv powder is white to off-white and forms a clear to slightly opalescent, colourless to pale yellow solution after reconstitution and dilution. A complete 1200 mg treatment course is prepared from three 400 mg single-dose vials.
Frequently Asked Questions About Orbactiv
Orbactiv is a hospital-administered medicine. It must be reconstituted and diluted by a trained pharmacy team and delivered as a three-hour intravenous infusion under medical supervision. Some specialist ambulatory infusion units and outpatient parenteral antimicrobial therapy (OPAT) services provide Orbactiv, allowing patients to receive a complete treatment course without a hospital admission. It is never self-administered at home.
Oritavancin has a terminal elimination half-life of approximately 245 hours, or about 10 days. Meaningful concentrations can persist in the blood and tissue for several weeks after a single 1200 mg dose. This is why coagulation test interference and some drug interactions need to be considered for up to 5 days (aPTT), up to 12 hours (PT/INR) and up to 24 hours (ACT) after administration.
No. Orbactiv is approved only for acute bacterial skin and skin structure infections in adults. It has not been shown to be effective for pneumonia, including community-acquired, hospital-acquired or ventilator-associated pneumonia, and it is not approved for bloodstream infections, endocarditis or osteomyelitis. Although bacteremia is commonly encountered in severe skin infections, treatment decisions in patients with confirmed bacteremia should always be individualized with infectious disease input.
Oritavancin is active against many Gram-positive bacteria, but its indications only cover vancomycin-susceptible Enterococcus faecalis in the context of ABSSSI. In vitro, oritavancin shows activity against some vancomycin-resistant Enterococcus strains carrying VanA and VanB, but clinical data in these situations are limited, and alternative targeted therapy should generally be selected when vancomycin resistance is confirmed.
Inform the nurse or doctor immediately. Most infusion-related rashes are mild and related to the rate of infusion. The team will typically slow or temporarily pause the infusion, treat the symptoms (for example with antihistamines), and then restart at a reduced rate. A severe rash, facial swelling, difficulty breathing or low blood pressure requires immediate stopping of the infusion and emergency treatment for a possible hypersensitivity reaction.
There is no specific pharmacokinetic interaction between oritavancin and alcohol. However, any acute infection severe enough to need Orbactiv requires adequate rest, hydration and follow-up care, and alcohol can interfere with wound healing and with other medications that may be prescribed. It is sensible to avoid alcohol until the infection has fully resolved and to discuss individual circumstances with the treating team.
References
- European Medicines Agency. Orbactiv (oritavancin) – Summary of Product Characteristics. EMA European Public Assessment Report. Available at: ema.europa.eu/en/medicines/human/EPAR/orbactiv
- U.S. Food and Drug Administration. Orbactiv (oritavancin) Prescribing Information. FDA.gov, updated 2024.
- Corey GR, Kabler H, Mehra P, et al. Single-dose oritavancin in the treatment of acute bacterial skin infections. New England Journal of Medicine 2014;370(23):2180–2190. doi:10.1056/NEJMoa1310422
- Corey GR, Good S, Jiang H, et al. 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 non-inferiority study. Clinical Infectious Diseases 2015;60(2):254–262. doi:10.1093/cid/ciu778
- Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections. Clinical Infectious Diseases (Infectious Diseases Society of America) 2014;59(2):e10–e52.
- Belley A, Neesham-Grenon E, McKay G, et al. Oritavancin kills stationary-phase and biofilm Staphylococcus aureus cells in vitro. Antimicrobial Agents and Chemotherapy 2009;53(3):918–925.
- Arhin FF, Draghi DC, Pillar CM, et al. Comparative in vitro activity profile of oritavancin against recent Gram-positive clinical isolates. Antimicrobial Agents and Chemotherapy 2009;53(11):4762–4771.
- Zhanel GG, Schweizer F, Karlowsky JA. Oritavancin: mechanism of action. Clinical Infectious Diseases 2012;54(Suppl 3):S214–S219.
- Joint Formulary Committee. British National Formulary (BNF). BMJ Group and Pharmaceutical Press; current edition. Oritavancin monograph.
- World Health Organization. Model List of Essential Medicines – Antibacterials. WHO Essential Medicines and Health Products, most recent revision.
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