Efficacy and Safety of Weekly Dalbavancin Therapy for Catheter-Related Bloodstream Infection Caused by Gram-Positive Pathogens

Raad, Issam; Darouiche, Rabih O.; Vázquez, José Antonio; Lentnek, Arnold; Hachem, Ray; Hanna, Hend; Goldstein, Beth P.; Henkel, Tim; Seltzer, Elyse

doi:10.1086/427283

Cited by 266 publications

(193 citation statements)

References 23 publications

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“…Case studies have described effective use of ceftaroline as a treatment option for daptomycinrefractory persistent MRSA bacteremia in patients with infectious endocarditis or osteomyelitis [164,165]. In several studies on catheter-associated BSI with gram-positive pathogens, the new lipoglycopeptide dalbavancin showed signifDer Anaesthesist icantly better outcomes than vancomycin in terms of clinical and microbiologic response rates [166,167]. The duration of therapy depends on the course of infection.…”

Section: Catheter-associated Infectionmentioning

confidence: 99%

Bacterial sepsis

et al. 2018

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Section: Catheter-associated Infectionmentioning

confidence: 99%

Bacterial sepsis

et al. 2018

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“…A phase II study compared dalbavancin (n = 33; 1000 mg loading dose on day 1 and 500 mg on day 8) with vancomycin (n = 34; 1000 mg every 12 h) for the treatment of catheter-related bloodstream infections [152] and concluded that dalbavancin was superior (clinical success rate: 87 vs. 50 %; microbiological success rate: 95.7 vs. 78.6 %). In both arms, success was higher when catheters were removed.…”

Section: Dalbavancinmentioning

confidence: 99%

Lipoglycopeptide Antibacterial Agents in Gram-Positive Infections: A Comparative Review

Bambeke

2015

Drugs

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Oritavancin, telavancin, and dalbavancin are recently marketed lipoglycopeptides that exhibit remarkable differences to conventional molecules. While dalbavancin inhibits the late stages of peptidoglycan synthesis by mainly impairing transglycosylase activity, oritavancin and telavancin anchor in the bacterial membrane by the lipophilic side chain linked to their disaccharidic moiety, disrupting membrane integrity and causing bacteriolysis. Oritavancin keeps activity against vancomycin-resistant enterocococci, being a stronger inhibitor of transpeptidase than of transglycosylase activity. These molecules have potent activity against Grampositive organisms, most notably staphylococci (including methicillin-resistant Staphylococcus aureus and to some extent vancomycin-intermediate S. aureus), streptococci (including multidrug-resistant pneumococci), and Clostridia. All agents are indicated for the treatment of acute bacterial skin and skin structure infections, and telavancin, for hospitalacquired and ventilator-associated bacterial pneumonia. While telavancin is administered daily at 10 mg/kg, the remarkably long half-lives of oritavancin and dalbavancin allow for infrequent dosing (single dose of 1200 mg for oritavancin and 1000 mg at day 1 followed by 500 mg at day 8 for dalbavancin), which could be exploited in the future for outpatient therapy. Among possible safety issues evidenced during clinical development were an increased risk of developing osteomyelitis with oritavancin; taste disturbance, nephrotoxicity, and risk of corrected QT interval prolongation (especially in the presence of at-risk co-medications) with telavancin; and elevation of hepatic enzymes with dalbavancin. Interference with coagulation tests has been reported with oritavancin and telavancin. These drugs proved non-inferior to conventional treatments in clinical trials but their advantages may be better evidenced upon future evaluation in more severe infections. Key PointsNew lipoglycopeptides (telavancin, oritavancin, dalbavancin) differ from vancomycin by the presence of a lipophilic side chain, which profoundly modifies their pharmacokinetic and/or pharmacodynamic profile.Among these agents, telavancin and oritavancin have multiple modes of action and are highly bactericidal.Oritavancin and dalbavancin have prolonged halflives, allowing for their use a single-dose or twodose (once-a-week) regimen, respectively. These three drugs are indicated for the treatment of acute bacterial skin and skin structure infections, and telavancin is indicated for hospital-acquired and ventilator-associated bacterial pneumonia.

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“…Animal models of infection show excellent activity against MRSA or GISA endocarditis, penicillin-resistant Streptococcus pneumoniae 12 pneumonia or MRSA pouch infection, and septicemia due to Staphylococci, Streptococci or Enterococci. This antibiotic has been evaluated for catheterrelated bacteremia 72 and skin and soft tissue infections. 73 Dalbavancin was effective and well tolerated in adult patients with catheter-related bacteremia caused by coagulasenegative Staphylococci, MSSA and MRSA in a comparative trial with vancomycin.…”

Section: Dalbavancinmentioning

confidence: 99%

Novel pharmaceutical molecules against emerging resistant gram-positive cocci

Manfredi¹,

Sabbatani²

2010

Braz J Infect Dis

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Introduction: methicillin-and also vancomycin (glycopeptide)-resistant Gram-positive organisms have emerged as an increasingly problematic cause of hospital-acquired infections, also spreading into the community. Vancomycin (glycopeptide) resistance has emerged primarily among Enterococci, but the MIC values of vancomycin for the entire Staphylococcus species are also increasing worldwide. Material and Methods: the aim of our review is to evaluate the efficacy and tolerability of newer antibiotics with activity against methicillin-resistant and glycopeptide-resistant Gram-positive cocci, on the ground of our experience at a tertiary care metropolitan Hospital, and the most recent literature evidences in this field. Results: Quinupristin-dalfopristin, linezolid, daptomycin, and tigecycline show an excellent in vitro activity, comparable to the activity of vancomycin and teicoplanin for methicillin-resistant staphylococci, and superior to the one that vancomycin for vancomycin-resistant isolates. Dalbavancin, televancin, and oritavancin are new lipoglycopeptide agents with excellent activity against Gram-positive cocci, and have superior pharmacodynamics properties compared to vancomycin. We review the bacterial spectrum, clinical indications and practical use, pharmacologic properties, and expected adverse events and contraindications associated with each of these novel antimicrobial agents, compared with the present standard of care. Discussion: linezolid activity is substantially comparable to that of vancomycin in patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, although its penetration into the respiratory tract is exceptionally elevated. Tigecycline has activity against both Enterococus species and MRSA; it is also active against a broad spectrum of Enterobacteriaceae and anaerobes, which allows for use intraabdominal, diabetic foot and surgical infections. Daptomycin has a rapid bactericidal activity for Staphylococcus aureus and it is approved in severe complications, such as bacteremia and right-sided endocarditis. It cannot be used to treat pneumonia and respiratory diseases, due to its inactivation in the presence of pulmonary surfactant.

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Efficacy and Safety of Weekly Dalbavancin Therapy for Catheter-Related Bloodstream Infection Caused by Gram-Positive Pathogens

Abstract: Dalbavancin thus appears to be an effective and well-tolerated treatment option for adult patients with CR-BSIs caused by CoNS and S. aureus, including MRSA.

Cited by 266 publications

References 23 publications

Bacterial sepsis

Bacterial sepsis

Lipoglycopeptide Antibacterial Agents in Gram-Positive Infections: A Comparative Review

Novel pharmaceutical molecules against emerging resistant gram-positive cocci

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