Dalbavancin: a review for dermatologists.
Author(s): Scheinfeld N(1).
Affiliation(s): Author information:
(1)Department of Dermatology, St Lukes Roosevelt Hospital, New York, NY, USA.
Scheinfeld@earthlink.net
Publication date & source: 2006, Dermatol Online J. , 12(4):6
Most complicated skin and skin structure infections (cSSSI) are caused by
Staphylococcus aurens (SA) and streptococcus (SC). More and more isolates of SA
and SC are resistant to methicillin (MRSA) and there are concerns that SA will
become resistant to vancomycin (VRSA), the current standard of treatment.
Dalbavancin (BI397) is a novel semisynthetic lipoglycopeptide that was designed
to improve uon the natural glycopeptides currently available, vancomycin and
teicoplanin. Phase-III clinical trials comprising more than 1,500 patients
evaluating once-weekly dalbavancin in skin and soft tissue infections (SSTIs)
associated with Gram-positive bacteria met the primary endpoint of
non-inferiority in patients whose clinical response was evaluated at 2 weeks
following therapy when compared to linezolid, cefazolin, or vancomycin, the three
most widely administered standard-of-care agents for SSTIs. The side effect
profile of dalbavancin is mild, with headache and pyrexia being the most adverse
effects. Once-a-week dosing with dalbavancin may obviate the need for the
continued presence of IV lines in some patients, which could translate into fewer
local infections and blood stream infections and which could facilitate transfer
of the patients to skilled nursing facilities. Unlike other new antibiotics, such
as oritavancin and tigecycline, dalbavancin is not active against
vancomycin-resistant enterococcus or VRSA. Its approval by the FDA is expected
soon. The extent to which dalbavancin will supplant vancomycin and whether it
will be preferred other newer agents such as linezolid.
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