[Dalbavancin photo]
Photo source: www.dalvance.com
KEY POINTS
- Dalbavancin (Dalvance) is a lipoglycopeptide that interferes with bacterial cell wall synthesis
- First FDA-approved in May 2014, now includes indications of:
- Acute bacterial skin and skin structure infections
- Has activity versus a variety of Gram positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA)
- Has two dosing regimens:
- Single-dose regimen of 1,500 mg intravenous once
- Two-dose regimen of 1,000 mg intravenous once, then 500 mg once a week later
- Adjust doses for renal impairment
- Administered over 30 minutes
- This was one benefit of dalbavancin over oritavancin, as oritavancin was infused over 3 hours but now has another brand Kimyrsa which has a one hour infusion
- Has been associated with infusion-mediated reactions
- Has an exceptionally long half-life (approximately 350 hours), making one dose enough for an entire treatment course at times
- Beware hepatic effects, hypersensitivity reactions, infusion reactions
- Expensive and not available in a generic formulation
- May be able to prevent hospitalization or reduce duration of hospitalization, but can be logistically challenging to implement
RESOURCES
- Dalbavancin Package Insert
- Single-Dose Dalbavancin: A Review in Acute Bacterial Skin and Skin Structure Infections (Drugs 2017)
- Dalbavancin and Oritavancin: An Innovative Approach to the Treatment of Gram-Positive Infections (Pharmacother 2015)
- Dalbavancin for the treatment of acute bacterial skin and skin structure infections (Expert Opin Pharmacother 2015)
- Effectiveness of Dalbavancin Compared With Standard of Care for the Treatment of Osteomyelitis: A Real-world Analysis (OFID 2021)
- Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System (CID 2021)
