cefilavancin

Cefilavancin is an investigational intravenous **glycopeptide-cephalosporin heterodimer antibiotic** developed by Theravance for serious Gram-positive bacterial infections, particularly complicated skin and skin-structure infections involving resistant *Staphylococcus aureus*. It covalently combines a vancomycin-derived glycopeptide pharmacophore with a cephalosporin moiety to produce multivalent inhibition of bacterial cell-wall synthesis. The glycopeptide component binds terminal D-alanyl-D-alanine residues of peptidoglycan precursors, while the cephalosporin component targets penicillin-binding proteins, including PBP2 in *Staphylococcus aureus*. A randomized Phase 2 study evaluated intravenous cefilavancin against vancomycin in complicated Gram-positive skin and skin-structure infections.