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Efficacy and Safety of Weekly Dalbavancin Therapy for Catheter-Related Bloodstream Infection Caused by Gram-Positive Pathogens

Background. Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dos...

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Published in:Clinical infectious diseases 2005-02, Vol.40 (3), p.374-380
Main Authors: Raad, Issam, Darouiche, Rabih, Vazquez, Jose, Lentnek, Arnold, Hachem, Ray, Hanna, Hend, Goldstein, Beth, Henkel, Tim, Seltzer, Elyse
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cited_by cdi_FETCH-LOGICAL-c482t-75ee11cca962fc785b721a3a5fd0544dbc3f06f26bbabd040366f994ce022aa83
cites cdi_FETCH-LOGICAL-c482t-75ee11cca962fc785b721a3a5fd0544dbc3f06f26bbabd040366f994ce022aa83
container_end_page 380
container_issue 3
container_start_page 374
container_title Clinical infectious diseases
container_volume 40
creator Raad, Issam
Darouiche, Rabih
Vazquez, Jose
Lentnek, Arnold
Hachem, Ray
Hanna, Hend
Goldstein, Beth
Henkel, Tim
Seltzer, Elyse
description Background. Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dosing regimen, possesses excellent activity against clinically important gram-positive bacteria, suggesting utility in the treatment of patients with CR-BSIs. Methods. A phase 2, open-label, randomized, controlled, multicenter study of 75 adult patients with CR-BSIs compared treatment with intravenous dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, with intravenous vancomycin, administered twice daily for 14 days. Gram-positive bacteria isolated in this study included coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Results. Infected patients who received weekly dalbavancin (n = 33) had an overall success rate (87.0%; 95% confidence interval [CI], 73.2%–100.0%) that was significantly higher than that of those who received vancomycin (n = 34) (50.0%; 95% CI, 31.5%–68.5%). Adverse events and laboratory abnormalities were generally mild and were comparable for the 2 drugs. Conclusions. Dalbavancin thus appears to be an effective and well-tolerated treatment option for adult patients with CR-BSIs caused by CoNS and S. aureus, including MRSA.
doi_str_mv 10.1086/427283
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Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dosing regimen, possesses excellent activity against clinically important gram-positive bacteria, suggesting utility in the treatment of patients with CR-BSIs. Methods. A phase 2, open-label, randomized, controlled, multicenter study of 75 adult patients with CR-BSIs compared treatment with intravenous dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, with intravenous vancomycin, administered twice daily for 14 days. Gram-positive bacteria isolated in this study included coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Results. Infected patients who received weekly dalbavancin (n = 33) had an overall success rate (87.0%; 95% confidence interval [CI], 73.2%–100.0%) that was significantly higher than that of those who received vancomycin (n = 34) (50.0%; 95% CI, 31.5%–68.5%). Adverse events and laboratory abnormalities were generally mild and were comparable for the 2 drugs. Conclusions. 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Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dosing regimen, possesses excellent activity against clinically important gram-positive bacteria, suggesting utility in the treatment of patients with CR-BSIs. Methods. A phase 2, open-label, randomized, controlled, multicenter study of 75 adult patients with CR-BSIs compared treatment with intravenous dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, with intravenous vancomycin, administered twice daily for 14 days. Gram-positive bacteria isolated in this study included coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Results. Infected patients who received weekly dalbavancin (n = 33) had an overall success rate (87.0%; 95% confidence interval [CI], 73.2%–100.0%) that was significantly higher than that of those who received vancomycin (n = 34) (50.0%; 95% CI, 31.5%–68.5%). Adverse events and laboratory abnormalities were generally mild and were comparable for the 2 drugs. Conclusions. Dalbavancin thus appears to be an effective and well-tolerated treatment option for adult patients with CR-BSIs caused by CoNS and S. aureus, including MRSA.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>15668859</pmid><doi>10.1086/427283</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Administered dose
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacteremia
Bacterial diseases
Biological and medical sciences
Blood
Catheters
Catheters, Indwelling - adverse effects
Clinical outcomes
Dosage
Drug Administration Schedule
Drug therapy
Female
General aspects
Glycopeptides
Human bacterial diseases
Human infectious diseases. Experimental studies and models
Humans
Infections
Infectious diseases
Major Articles
Male
Medical sciences
Middle Aged
Pathogens
Pharmacology. Drug treatments
Staphylococcal infections, streptococcal infections, pneumococcal infections
Staphylococcus aureus
Teicoplanin - adverse effects
Teicoplanin - analogs & derivatives
Teicoplanin - therapeutic use
Vancomycin - adverse effects
Vancomycin - therapeutic use
title Efficacy and Safety of Weekly Dalbavancin Therapy for Catheter-Related Bloodstream Infection Caused by Gram-Positive Pathogens
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