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A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
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A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

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Dalbavancin in the Real-World Management of Gram-Positive Infections: A Systematic Review of Randomized and

Claudio Tana1, Livia Moffa2, Marco Tana3

  • 1Internal Medicine Unit, Eastern Hospital, ASL Taranto, 74024 Manduria, Italy.

Microorganisms
|May 27, 2026
PubMed

Insights

Dalbavancin, a long-acting antibiotic, shows effectiveness and safety for various Gram-positive infections beyond skin infections. It simplifies treatment, reduces hospital stays, and offers potential cost savings, especially in complex cases.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Medicine

Background:

  • Gram-positive infections cause significant illness and high healthcare costs, often needing lengthy intravenous treatments.
  • Dalbavancin, a lipoglycopeptide antibiotic, is approved for acute bacterial skin and skin structure infections (ABSSSI) but shows promise for other Gram-positive infections.

Purpose of the Study:

  • To systematically review the clinical effectiveness, safety, and healthcare resource utilization of dalbavancin for Gram-positive infections.
  • To evaluate dalbavancin's role in both approved and off-label indications.

Main Methods:

  • A systematic review following PRISMA guidelines, searching MEDLINE, Embase, CENTRAL, and Web of Science.
  • Inclusion of randomized controlled trials (RCTs) and observational studies in adult patients with Gram-positive infections.
  • Assessment of clinical efficacy, safety, and healthcare resource utilization, with risk of bias evaluation.

Main Results:

  • RCTs confirmed dalbavancin's non-inferior efficacy compared to standard therapy for ABSSSI.
  • Observational studies showed high success rates in osteo-articular infections, bloodstream infections, and infective endocarditis, particularly in acute settings.
  • Dalbavancin use was linked to shorter hospital stays, outpatient management facilitation, and potential cost savings, with a favorable safety profile.

Conclusions:

  • Dalbavancin is an effective and safe option for Gram-positive infections, with growing evidence for complex and off-label uses.
  • Its pharmacokinetic properties allow for simplified treatment and improved healthcare resource utilization.
  • Appropriate patient selection and source control are crucial for optimal outcomes with dalbavancin therapy.
Keywords:
dalbavancingram-positive infectionslong-acting antibioticsoutpatient parenteral antimicrobial therapy (OPAT)real-world evidence

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