Dalbavancin plasma concentrations in 133 patients: a PK/PD observational study

Area of Science:

• Pharmacology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Limited pharmacokinetic data exists for dalbavancin in off-label indications.
• Optimal dalbavancin dosing regimens require further investigation.
• Dalbavancin is a lipoglycopeptide antibiotic used for serious Gram-positive bacterial infections.

Purpose of the Study:

• To describe dalbavancin plasma concentrations in a real-world setting.
• To investigate the impact of patient weight and renal function on dalbavancin pharmacokinetics.
• To provide data supporting the long-term use and dosing of dalbavancin.

Main Methods:

• Observational, retrospective, multicenter study including 133 patients from 13 French hospitals.
• Dalbavancin plasma concentrations measured at various time points post-dose (peak to 8 weeks).
• Comparison of concentrations based on weight (<75 kg vs. >75 kg) and renal function (GFR <60 mL/min vs. >60 mL/min).

Main Results:

• Median plasma concentrations at 2, 3, and 4 weeks were 25.00, 14.80, and 9.24 mg/L for single doses, and 34.55, 22.60, and 19.20 mg/L for multiple doses.
• Patient weight and renal function significantly impacted dalbavancin pharmacokinetics.
• Commonly isolated pathogens included Staphylococcus spp. (68%), with S. aureus and S. epidermidis having a median MIC of 0.047 mg/L.

Conclusions:

• Dalbavancin plasma concentrations observed in this study align with those reported in clinical trials.
• The findings support the consistency of dalbavancin levels in clinical practice.
• This data can inform optimal dosing strategies for dalbavancin in various patient populations.