Purpose: The activity, pharmacokinetics, pharmacodynamics, efficacy, safety, and formulary considerations of dalbavancin are reviewed.
Summary: Dalbavancin is a novel second-generation lipoglycopeptide antimicrobial with unique pharmacokinetics and excellent activity against resistant gram-positive pathogens, including methicillin-resistant Staphylococcus aureus. Available only in i.v. form, it exhibits excellent tissue penetration, particularly in the skin, and a long half-life that allows once-weekly administration. Clinically relevant drug interactions involving dalbavancin have not been identified. While sharing a similar mechanism of action and spectrum of activity with other glycopeptides, dalbavancin has demonstrated in vitro and in vivo bactericidal potency superior to that of vancomycin, teicoplanin, and other commonly used antimicrobials. Clinical trials indicate that dalbavancin is efficacious for skin and soft-tissue infections and catheter-related bloodstream infections. Dalbavancin appears to be noninferior to linezolid and superior to vancomycin. Adverse events are mild to moderate and include pyrexia, headache, and nausea.
Conclusion: Dalbavancin has enhanced activity against gram-positive bacteria and unique pharmacokinetics compared with existing drugs in its class. It appears to be safe and efficacious for use against common infections, including complicated skin infections and catheter-related bloodstream infections.