Efficacy and safety of dalbavancin in the treatment of Gram-positive bacterial infections

Wang, Yuhang; Wang, Jin; Wang, Rui; Li, Yuanyuan; Cai, Yun

doi:10.1016/j.jgar.2020.11.018

Cited by 12 publications

(14 citation statements)

References 35 publications

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“… 80 A recent meta-analysis including seven RCTs investigating dalbavancin in different settings (ABSSSIs, CR-BSIs, and osteomyelitis) found no significant difference in terms of any AEs (OR 1.58; 95% CI 0.82–3.02), adverse drug reactions (OR 0.85; 95% CI 0.61–1.19), and specific AEs (including nausea, headache, constipation, hypertension, vomiting, rash, pyrexia, anaemia, fungal infection, alanine aminotransferase elevation and gamma-glutamyl transferase elevation) between dalbavancin and comparators. 81 When compared with vancomycin or linezolid, the incidence of diarrhoea was significantly lower in patients receiving dalbavancin (OR 0.38; 95% CI 0.21–0.68). 81 Notably, there was no significant difference in serious AEs (OR 0.80; 95% CI 0.55–1.17).…”

Section: Safetymentioning

confidence: 95%

“… 81 When compared with vancomycin or linezolid, the incidence of diarrhoea was significantly lower in patients receiving dalbavancin (OR 0.38; 95% CI 0.21–0.68). 81 Notably, there was no significant difference in serious AEs (OR 0.80; 95% CI 0.55–1.17). 81 …”

Section: Safetymentioning

confidence: 95%

“…79 Dunne et al 80 performed a pooled analysis of 3002 patients enrolled in seven phase II/III RCTs receiving dalbavancin (N = 1778) or comparators (N = 1224), including vancomycin, linezolid, nafcillin, oxacillin, and cephalosporins. Patients treated with dalbavancin experienced a significantly lower number of overall 81 When compared with vancomycin or linezolid, the incidence of diarrhoea was significantly lower in patients receiving dalbavancin (OR 0.38; 95% CI 0.21-0.68). 81 Notably, there was no significant difference in serious AEs (OR 0.80; 95% CI 0.55-1.17).…”

Section: Safetymentioning

confidence: 97%

“…Patients treated with dalbavancin experienced a significantly lower number of overall 81 When compared with vancomycin or linezolid, the incidence of diarrhoea was significantly lower in patients receiving dalbavancin (OR 0.38; 95% CI 0.21-0.68). 81 Notably, there was no significant difference in serious AEs (OR 0.80; 95% CI 0.55-1.17). 81 The excellent safety profile was also confirmed in reallife studies evaluating dalbavancin use in off-label settings (e.g., endocarditis, BSIs, osteomyelitis, joint infections), in which the overall proportion of AEs ranged from 0% to 13%.…”

Section: Safetymentioning

confidence: 97%

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Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs

Gatti

Andreoni

Pea

et al. 2021

DDDT

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Dalbavancin is a novel, long-acting lipoglycopeptide characterized by a long elimination half-life coupled with excellent in vitro activity against multidrug-resistant Gram-positives. Although it is currently approved only for the treatment of acute bacterial skin and skin structure infections, an ever-growing amount of evidence supports the efficacy of dalbavancin as a long-term therapy in osteomyelitis, prosthetic joint infections, endocarditis, and bloodstream infections. This article provides a critical reappraisal of real-world use of dalbavancin for off-label indications. A search strategy using specific keywords (dalbavancin, osteomyelitis, endocarditis, long-term suppressive therapy, bloodstream infection, pharmacokinetic/pharmacodynamic profile) until April 2021 was performed on the PubMed-MEDLINE database. As for other novel antibiotics, a conundrum between approved indications and potential innovative therapeutic uses has emerged for dalbavancin as well. The promising efficacy in challenging scenarios (i.e., osteomyelitis, endocarditis, prosthetic joint infections), coupled with the unique pharmacokinetic/pharmacodynamic properties, makes dalbavancin a valuable alternative to daily in-hospital intravenous or outpatient antimicrobial regimens in the treatment of long-term Gram-positive infections. This makes dalbavancin valuable in the current COVID-19 scenario, in which hospitalization and territorial medicine empowerment are unavoidable.

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Section: Safetymentioning

confidence: 95%

Section: Safetymentioning

confidence: 95%

Section: Safetymentioning

confidence: 97%

Section: Safetymentioning

confidence: 97%

See 2 more Smart Citations

Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs

Gatti

Andreoni

Pea

et al. 2021

DDDT

View full text Add to dashboard Cite

show abstract

“…To date, available data on the in vitro efficacy of dalbavancin mainly come from complementary clinical studies [ 22 , 23 , 24 , 25 , 26 ]. However, within these studies, enterococci were hardly considered, and many of these studies have been conducted in the USA, where the majority of E. faecium infections is caused by vanA -type VRE.…”

Section: Discussionmentioning

confidence: 99%

Determination of a Tentative Epidemiological Cut-Off Value (ECOFF) for Dalbavancin and Enterococcus faecium

et al. 2021

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Dalbavancin is a lipoglycopeptide antibiotic that shows potent activity against Gram-positive bacteria. It circumvents vanB-type glycopeptide resistance mechanisms; however, data on the in vitro activity of dalbavancin for Enterococcus faecium (E. faecium) are scarce, and thus, no breakpoints are provided. In recent years, there has been a continuing shift from vanA-type to vanB-type vancomycin-resistance in enterococci in Central Europe. Therefore, we aimed to investigate the in vitro activity of dalbavancin against different van-genotypes, with particular focus on vanB-type E. faecium. Dalbavancin susceptibility was determined for 25 van-negative, 50 vanA-positive, and 101 vanB-positive clinical E. faecium isolates (typed by cgMLST). Epidemiological Cut-Off Values (ECOFFs) were determined using ECOFFinder. For vanB-type E. faecium isolates, dalbavancin MICs were similar to those of vancomycin-susceptible isolates reaching values no higher than 0.125 mg/L. ECOFFs for van-negative and vanB-positive isolates were 0.5 mg/l and 0.25 mg/L respectively. In contrast, E. faecium possessing vanA predominantly showed dalbavancin MICs >8 mg/L, therefore preventing the determination of an ECOFF. We demonstrated the potent in vitro activity of dalbavancin against vancomycin-susceptible and vanB-type E. faecium. On the basis of the observed wildtype distribution, a dalbavancin MIC of 0.25 mg/L can be suggested as a tentative ECOFF for E. faecium.

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The Role of Novel Antibiotics in the Management of Diabetic Foot Infection

et al. 2022

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Diabetic foot infection is a frequent and potentially life-threatening complication of diabetes mellitus. Antibiotic treatment is the cornerstone of management of diabetic foot infection but the rising prevalence of antibiotic resistance has resulted in increasing rates of treatment failure. In this context, the development of several novel antibiotics might represent a useful tool in severe diabetic foot infections caused by multidrug-resistant bacteria. In the present review, we summarize the safety and efficacy of novel antibiotics in patients with diabetic foot infection. Relevant data are limited, and randomized controlled studies that evaluated the role of these agents in this field are lacking. Until more robust data are available, cefiderocol and dalbavancin, which have been studied more extensively in patients with bone infections, might be attractive options in carefully selected patients with severe diabetic foot infection.

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Efficacy and safety of dalbavancin in the treatment of Gram-positive bacterial infections

Cited by 12 publications

References 35 publications

Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs

Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs

Determination of a Tentative Epidemiological Cut-Off Value (ECOFF) for Dalbavancin and Enterococcus faecium

The Role of Novel Antibiotics in the Management of Diabetic Foot Infection

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