Efficacy and safety of weekly dalbavancin therapy for catheter-related bloodstream infection caused by gram-positive pathogens.
BACKGROUND
Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dosing regimen, possesses excellent activity against clinically important gram-positive bacteria, suggesting utility in the treatment of patients with CR-BSIs.


METHODS
A phase 2, open-label, randomized, controlled, multicenter study of 75 adult patients with CR-BSIs compared treatment with intravenous dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, with intravenous vancomycin, administered twice daily for 14 days. Gram-positive bacteria isolated in this study included coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA).


RESULTS
Infected patients who received weekly dalbavancin (n=33) had an overall success rate (87.0%; 95% confidence interval [CI], 73.2%-100.0%) that was significantly higher than that of those who received vancomycin (n=34) (50.0%; 95% CI, 31.5%-68.5%). Adverse events and laboratory abnormalities were generally mild and were comparable for the 2 drugs.


CONCLUSIONS
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.
Raad
Issam
I
The M. D. Anderson Cancer Center, Houston, TX, USA.
Darouiche
Rabih
R
Vazquez
Jose
J
Lentnek
Arnold
A
Hachem
Ray
R
Hanna
Hend
H
Goldstein
Beth
B
Henkel
Tim
T
Seltzer
Elyse
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016470:Bacteremia; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017334:Teicoplanin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin; C469289:dalbavancin