title: Efficacy and safety of weekly dalbavancin therapy for catheter-related bloodstream infection caused by gram-positive pathogens.
abstract: 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.
authors.affiliation: The M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Issam
authors.initials: I
authors.lastname: Raad
authors.forename: Rabih
authors.initials: R
authors.lastname: Darouiche
authors.forename: Jose
authors.initials: J
authors.lastname: Vazquez
authors.forename: Arnold
authors.initials: A
authors.lastname: Lentnek
authors.forename: Ray
authors.initials: R
authors.lastname: Hachem
authors.forename: Hend
authors.initials: H
authors.lastname: Hanna
authors.forename: Beth
authors.initials: B
authors.lastname: Goldstein
authors.forename: Tim
authors.initials: T
authors.lastname: Henkel
authors.forename: Elyse
authors.initials: E
authors.lastname: Seltzer
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin; C469289:dalbavancin