Kristin H. Busse¹, Kate M. Oltrogge², Carolyn J. Oxencis³ and William J. Peppard⁴

¹Investigational Drug Pharmacist, Froedtert Hospital, Milwaukee, Wisconsin, USA. ²Critical Care Pharmacy Resident, Froedtert Hospital, Milwaukee, Wisconsin, USA. ³Neurosurgical Critical Care Pharmacist, Froedtert Hospital, Milwaukee, Wisconsin, USA. ⁴Surgical Critical Care Pharmacist, Froedtert Hospital, Milwaukee, Wisconsin, USA.  

Abstract

Dalbavancin is an intravenous semisynthetic lipoglycopeptide which has demonstrated potent in vitro activity again most clinically significant Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus, vancomycin-intermediate Staphylococcus aureus, and some vancomycin-resistant Enterococci. The long half-life of dalbavancin allows for once weekly dosing. In published clinical trials, a dose on day 1 and 8 of treatment provided 14 days of antimicrobial activity. In clinical trials, dalbavancin has demonstrated non-inferiority as measured by safety and efficacy for the treatment of uncomplicated skin and skin structure infections (Phase II as compared to cefazolin), catheter-related bloodstream infections (Phase II as compared to vancomycin), and complicated skin and skin structure infections (Phase III as compared to linezolid). Due to feedback from the Food and Drug Administration, all marketing has been withdrawn and an additional phase III trial is currently underway; therefore the future for dalbavancin is unclear. An acquisition cost has not yet been projected; consequently pharmacoeconomic analyses are not yet underway.