The historical gold standard for the treatment of infections caused by resistant Gram-positive pathogens has been vancomycin. Unfortunately, contemporary use of vancomycin has been tempered by increasing rates of resistance among pathogens such as Staphylococcus aureus and Enterococcus spp. Telavancin, a novel glycopeptide is bactericidal against Gram-positive microorganisms, including vancomycin-resistant strains. Telavancin (Vibativ; Therevance/Astellas Pharma), a lipoglycopeptide derivative of vancomycin once-daily injectable antibiotic, was approved by FDA in 2009 for the treatment of adults patients with complicated skin and skin structure infections (cSSSI) caused by susceptible isolates of the following Gram-positive microorganisms: S. aureus, including methicillin-susceptible (MSSA) and methicillin–resistant (MRSA) isolates, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus group and Enterococcus faecalis (vancomycin-susceptible isolates only). Telavancin has a dual mechanism of action – inhibiting bacterial cell wall synthesis and disturbing bacteria cell membrane function.