New antimicrobial agents have been developed to treat infections caused by methicillin-resistant Staphylococcus aureus and other multidrug-resistant pathogens. Dalbavancin is a novel semisynthetic lipoglycopeptide antibiotic, particularly active against methicillin-resistant Staphylococcus aureus. Due to its unique pharmacological characteristics and longer half-life, it can be administered once-weekly or every 15 days and in outpatient setting. Currently, it is indicated for complicated skin and soft tissue infections, but accumulating evidence points to its off-label efficacy in osteomyelitis and endocarditis. Further experience is still needed to increase our knowledge on the role of dalbavancin in a wider range of Gram-positive infections requiring prolonged antimicrobial treatment.
US Department of Health and Human Services Food and Drug Administration, Center for Drug Evaluation and Research (CDER). Guidance for industry. Acute bacterial skin and skin structure infections: developing drugs for treatment. http://www.fda.gov/downloads/Drugs/./Guidances/ucm071185.pdf. Published October 2013. Accessed April 17, 2020.
2.
StevensDLBisnoALChambersHF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59:147-159.
3.
LipskyBASilvermanMHJosephWS.A proposed new classification of skin and soft tissue infections modeled on the subset of diabetic foot infection. Open Forum Infect Dis. 2017;4:ofw255.
4.
PallinDJEganDJPelletierAJ, et al. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistantStaphylococcus aureus. Ann Emerg Med. 2008;51:291-298.
5.
MillerLGEisenbergDFLiuH, et al. Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005-2010. BMC Infect Dis. 2015;15:362.
6.
HershALChambersHFMaselliJHGonzalesR.National trends in ambulatory visits and antibiotic prescribing for skin and soft tissue infections. Arch Intern Med. 2008;168:1585-1591.
NathwaniDDrydenMGarauJ.Early clinical assessment of response to treatment of skin and soft-tissue infections: how can it help clinicians? Perspectives from Europe. Int J Antimicrob Agents. 2016;48:127-136.
9.
SaderHSFarrellDJJonesRN.Antimicrobial susceptibility of Gram-positive cocci isolated from skin and skin-structure infections in European medical centres. Int J Antimicrob Agents. 2010;36:28-32.
10.
GarauJOstermannHMedinaJ, et al. Current management of patients hospitalized with complicated skin and soft tissue infections across Europe (2010-2011): assessment of clinical practice patterns and real-life effectiveness of antibiotics from the REACH study. Clin Microbiol Infect. 2013;19:E377-E385.
CitronDMGoldsteinEJMerriamCVLipskyBAAbramsonMA.Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol. 2007;45:2819-2828.
13.
BassettiMCarneluttiARighiE.The role of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections. Curr Opin Infect Dis. 2017;30:150-157.
14.
ZhanelGGCalicDSchweizerF, et al. New lipoglycopeptides: a comparative review of dalbavancin, oritavancin and telavancin. Drugs. 2010;70:859-886.
LeuthnerKDBuechlerKAKoganDSagurosALeeHS.Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI). Ther Clin Risk Manag. 2016;12:931-940.
17.
MorrisetteTMillerMAMontagueBTBarberGRMcQueenRBKrsakM.On- and off-label utilization of dalbavancin and oritavancin for Gram-positive infections. J Antimicrob Chemother. 2019;74:2405-2416.
18.
StewartCLTurnerMSFrensJJSniderCBSmithJR.Real-world experience with oritavancin therapy in invasive Gram-positive infections. Infect Dis Ther. 2017;6:277-289.
19.
SchulzLTDworkinEDela-PenaJRoseWE.Multiple-dose oritavancin evaluation in a retrospective cohort of patients with complicated infections. Pharmacotherapy. 2018;38:152-159.
20.
SosioMStinchiSBeltramettiFLazzariniADonadioS.The gene cluster for the biosynthesis of the glycopeptide antibiotic A40926 by Nonomuraea species. Chem Biol. 2003;10:541-549.
21.
BaileyJSummersKM.Dalbavancin: a new lipoglycopeptide antibiotic. Am J Health Syst Pharm. 2008;65:599-610.
22.
NagarajanR.Minireview: antibacterial activities and modes of action of vancomycin and related glycopeptides. Antimicrob Agents Chemother. 1991;35:605-609.
23.
AllenNELeTourneauDLHobbsJNJrThompsonRC.Hexapeptide derivatives of glycopeptide antibiotics: tools for mechanism of action studies. Antimicrob Agents Chemother. 2002;46:2344-2348.
24.
MalabarbaAGoldsteinBP.Origin, structure, and activity in vitro and in vivo of dalbavancin. J Antimicrob Chemother. 2005;55(suppl 2):ii15-ii20.
25.
ChenAYZervosMJVazquezJA.Dalbavancin: a novel antimicrobial. Int J Clin Pract. 2007;61:853-863.
26.
MarburyTDowellJASeltzerEBuckwalterM.Pharmacokinetics of dalbavancin in patients with renal or hepatic impairment. J Clin Pharmacol. 2009;49:465-476.
27.
DunneMWPuttaguntaSSprengerCRRubinoCVan WartSBaldassarreJ.Extended-duration dosing and distribution of dalbavancin into bone and articular tissue. Antimicrob Agents Chemother. 2015;59:1849-1855.
BuckwalterMDowellJA.Population pharmacokinetic analysis of dalbavancin, a novel lipoglycopeptide. J Clin Pharmacol. 2005;45:1279-1287.
30.
StogniewMPuFDowellJAHenkelT.Pharmacokinetic attributes of dalbavancin: well distributed and completely eliminated with dual routes of elimination. Clin Microbiol Infect. 2003;9(suppl 1):291.
31.
BowkerKENoelARMacGowanAP.Pharmacodynamics of dalbavancin studied in an in vitro pharmacokinetics system. J Antimicrob Chemother. 2006;58:802-805.
32.
LinGCreditoKEdnieLMAppelbaumPC.Antistaphylococcal activity of dalbavancin, an experimental glycopeptides. Antimicrob Agents Chemother. 2005;49:770-772.
33.
StreitJMFritscheTRSaderHSJonesRN.Worldwide assessment of dalbavancin activity and spectrum against over 6000 clinical isolates. Diagn Microbiol Infect Dis. 2004;48:137-143.
34.
LopezSHackbarthCRomanoGTriasJJabesDGoldsteinBP.In vitro antistaphylococcal activity of dalbavancin, a novel glycopeptide. J Antimicrob Chemother. 2005;55(suppl 2):ii21-ii24.
35.
CitronDMTyrellKLGoldsteinEJ.Comparative in vitro activities of dalbavancin and seven comparator agents against 41 Staphylococcus species cultured from osteomyelitis infections and 18 VISA and hVISA strains. Diagn Microbiol Infect Dis. 2014;79:438-440.
GoldsteinEJCitronDMMerriamCVWarrenYTyrrellKFernandezHT.In vitro activities of dalbavancin and nine comparator agents against anaerobic gram-positive species and Corynebacteria. Antimicrob Agents Chemother. 2003;47:1968-1971.
38.
JohnsonDMFritscheTRSaderHSJonesRN.Evaluation of dalbavancin in combination with nine antimicrobial agents to detect enhanced or antagonistic interactions. Int J Antimicrob Agents. 2006;27:557-560.
39.
KlinkerKPBorgertSJ.Beyond vancomycin: the tail of the lipoglycopeptides. Clin Ther. 2015;37:2619-2636.
BoucherHWWilcoxMTalbotGHPuttaguntaSDasAFDunneMW.Once-weekly dalbavancin versus daily conventional therapy for skin infection. N Engl J Med. 2014;370:2169-2179.
42.
DunneMWTalbotGHBoucherHWWileoxMPuttaguntaS.Safety of dalbavancin in the treatment of skin and skin structure infections: a pooled analysis of randomized comparative studies. Drug Saf. 2016;39:147-157.
43.
JaureguiLEBabazadehSSeltzerE, et al. Randomized, double-blind comparison of once-weekly versus twice-daily linezolid therapy for the treatment of complicated skin and skin structure infections. Clin Infect Dis. 2005;41:1407-1415.
44.
DunneMWPuttaguntaSGiordanoPKrievinsDZelaskyMBaldassarreJ.A randomized clinical trial of single-dose versus weekly dalbavancin for treatment of acute bacterial skin and skin structure infection. Clin Infect Dis. 2016;62:545-551.
45.
LogmanJFStephensJHeegB, et al. Comparative effectiveness of antibiotics for the treatment of MRSA complicated skin and soft tissue infections. Curr Med Res Opin. 2010;26:1565-1578.
46.
AgarwalRBartschSMKellyBJ, et al. Newer glycopeptide antibiotics for treatment of complicated skin and soft tissue infections: systematic review, network meta-analysis and cost analysis. Clin Microbiol Infect. 2018;24:361-368.
47.
BouzaEValerioMSorianoA, et al. Dalbavancin in the treatment of different gram-positive infections: a real-life experience. Int J Antimicrob Agents. 2018;51:571-577.
48.
JuulJJMullinsCFPeppardWJHuangAM.New developments in the treatment of acute bacterial skin and skin structure infections: considerations for the effective use of dalbavancin. Ther Clin Risk Manag. 2016;12:225-232.
49.
PollackCVJrAminAFordWTJr, et al. Acute bacterial skin and skin structure infections (ABSSSI): practice guidelines for management and care transitions in the emergency department and hospital. J Emerg Med. 2015;48:508-519.
50.
WunschSKrauseRValentinT, et al. Multicenter clinical experience of real life dalbavancin use in gram-positive infections. Int J Infect Dis. 2019;81:210-214.
51.
RappoUPuttaguntaSShevchenkoV, et al. Dalbavancin for the treatment of osteomyelitis in adult patients: a randomized clinical trial of efficacy and safety. Open Forum Infect Dis. 2018;6:ofy331.
52.
AlmangourTAPerryGKTerriffCMAlhifanyAAKayeKS.Dalbavancin for the management of gram-positive osteomyelitis: effectiveness and potential utility. Diagn Microbiol Infect Dis. 2019;93:213-218.
53.
MorataLCoboJFernández-SampedroM, et al. Safety and efficacy of prolonged use of dalbavancin in bone and joint infections. Antimicrob Agents Chemother. 2019;63:e02280-e02318.
54.
GoldsteinEJCitronDMWarrenYATyrrellKLMerriamCVFernandezHT.In vitro activities of dalbavancin and 12 other agents against 329 aerobic and anaerobic gram-positive isolates recovered from diabetic foot infections. Antimicrob Agents Chemother. 2006;50:2875-2879.
55.
TobudicSForstnerCBurgmannH, et al. Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection. Infection. 2019;47:1013-1020.
56.
MartínLBFernándezMMRuizJMP, et al. Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: a proposal for a low dose strategy. A retrospective cohort study. Rev Esp Quimioter. 2019;32:532-538.
57.
ZimmerliWTrampuzAOchsnerPE.Prosthetic-joint infections. N Engl J Med. 2004;351:1645-1654.
58.
KnafDTobudicSChengSCBellamyDRThalhammerF.Dalbavancin reduces bioflms of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE). Eur J Clin Microbiol Infect Dis. 2017;36:677-680.
59.
NeudorferKSchmidt-MalanSMPatelR.Dalbavancin is active in vitro against biofilms formed by dalbavancin-susceptible enterococci. Diagn Microbiol Infect Dis. 2018;90:58-63.
