Dalbavancin: A Review in Acute Bacterial Skin and Skin Structure Infections

Intravenous dalbavancin (Dalvance™; Xydalba™) is approved for use in adult patients with acute bacterial skin and skin structure infections (ABSSSI), with the recommended regimen being a 1000 mg dose followed 1 week later by a 500 mg dose. In the multinational DISCOVER 1 and 2 trials in adult patients with ABSSSI, dalbavancin treatment was noninferior to vancomycin (for ≥ 3 days with an option to switch to oral linezolid to complete a 10- to 14-day course) in terms of early clinical success rates (assessed 48-72 h after initiation of treatment; primary endpoint required by the FDA to assess noninferiority in registration trials of ABSSSI). Clinical response rates were also similar in both treatment groups at the end of treatment (day 14-15), irrespective of geographic region or baseline characteristics, including by infection type, diabetes mellitus status, systemic inflammatory response syndrome status, causative pathogen and renal function. Dalbavancin was generally well tolerated, with adverse events generally being of mild to moderate intensity and transient. With its broad spectrum of activity against clinically relevant Gram-positive pathogens and its favourable pharmacokinetic profile that permits a convenient two-dose, once-weekly regimen with no requirement for therapeutic drug monitoring, dalbavancin is a promising emerging option for the treatment of ABSSSI in adult patients.