What the class is
A glycopeptide is a peptide that carries sugar groups. In the antibiotics of this class, the peptide part is a ring of amino acids — many of them unusual, chlorinated or cross-linked — folded into a cup-shaped structure. The Vancocin label describes vancomycin as "a tricyclic glycopeptide antibiotic" made by the soil bacterium Amycolatopsis orientalis, with the formula C66H75Cl2N9O24·HCl.
The newer members add a fatty side chain to that core. Their labels call them lipoglycopeptides. Dalbavancin's label sets out a single-dose regimen, or two doses one week apart, against telavancin's once-daily infusion for 7 to 14 days; how the fatty tail contributes to that difference was not re-read in this run.
Every indication in the table below names Gram-positive bacteria. None of the four labels lists a Gram-negative infection.
The members, by US label
| Drug | Brand (US) | Approved (Drugs@FDA) | Type | Indication in the label |
|---|---|---|---|---|
| Vancomycin | Vancocin and generics | Capsules: 1986-04-15 (NDA 050606) | Glycopeptide | Oral: C. difficile diarrhoea and staphylococcal enterocolitis; intravenous forms: serious Gram-positive infections |
| Telavancin | Vibativ | 2009-09-11 | Lipoglycopeptide | Complicated skin infections; hospital and ventilator pneumonia caused by S. aureus when alternatives are unsuitable |
| Dalbavancin | Dalvance | 2014-05-23 | Lipoglycopeptide | Acute bacterial skin infections, adults and children |
| Oritavancin | Orbactiv; Kimyrsa | 2014-08-06; 2021-03-12 | Lipoglycopeptide | Acute bacterial skin infections, adults |
The table is a census in date order, not a ranking. The labels themselves warn against comparing rates across trials.
Two oritavancin products. Kimyrsa's label states that Orbactiv and Kimyrsa differ in dose strength, infusion time and preparation, and are not interchangeable in how they are made up.
Vancomycin's dates. Drugs@FDA lists the capsule application from 1986, but the drug is much older: a 2006 history in Clinical Infectious Diseases (PMID 16323120) says it became available "more than 50 years ago", fell out of use, and returned as MRSA and C. difficile spread.
What the labels warn about
- Telavancin (Vibativ) carries a boxed warning: increased mortality among hospital-pneumonia patients with moderate or severe kidney impairment (creatinine clearance 50 mL/min or less), nephrotoxicity, and potential harm to a developing baby.
- Every label in the class carries the standard antibiotic-stewardship line: use only for infections proven or strongly suspected to be caused by susceptible bacteria.
- Resistance is part of the class's history. The 2006 review records vancomycin resistance appearing first in enterococci and later in staphylococci.
What is not established here
- This entry does not compare the members' effectiveness. Their trials were run against different comparators, and choosing an antibiotic is a prescriber's decision.
- Teicoplanin's approvals outside the US were not checked in this run; only its absence from Drugs@FDA was.
- The microbiology of each drug was summarised from the class description, not re-read member by member.
Where it stands
| Question | Answer as of 2026-11-10 |
|---|---|
| Members approved in the US | Vancomycin, telavancin, dalbavancin, oritavancin (two products) |
| Teicoplanin | No US application found |
| Who they treat | Gram-positive infections, including MRSA; oral vancomycin for C. difficile |
| Published record | 1,511 PubMed records naming the class; 17 randomised trials |
| Advice | None given here |
Related reading
Other peptide antibiotics in the library work in different ways: daptomycin is a lipopeptide that disrupts bacterial membranes, bacitracin is a cyclic peptide used on the skin, and colistin and polymyxin B act on Gram-negative bacteria, the group glycopeptides cannot reach.