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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 |
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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. 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.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/427283</identifier><identifier>PMID: 15668859</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>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</subject><ispartof>Clinical infectious diseases, 2005-02, Vol.40 (3), p.374-380</ispartof><rights>Copyright 2005 The Infectious Diseases Society of America</rights><rights>2005 by the Infectious Diseases Society of America 2005</rights><rights>2005 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Feb 1, 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-75ee11cca962fc785b721a3a5fd0544dbc3f06f26bbabd040366f994ce022aa83</citedby><cites>FETCH-LOGICAL-c482t-75ee11cca962fc785b721a3a5fd0544dbc3f06f26bbabd040366f994ce022aa83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4484094$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4484094$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,58593,58826</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16611758$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15668859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raad, Issam</creatorcontrib><creatorcontrib>Darouiche, Rabih</creatorcontrib><creatorcontrib>Vazquez, Jose</creatorcontrib><creatorcontrib>Lentnek, Arnold</creatorcontrib><creatorcontrib>Hachem, Ray</creatorcontrib><creatorcontrib>Hanna, Hend</creatorcontrib><creatorcontrib>Goldstein, Beth</creatorcontrib><creatorcontrib>Henkel, Tim</creatorcontrib><creatorcontrib>Seltzer, Elyse</creatorcontrib><title>Efficacy and Safety of Weekly Dalbavancin Therapy for Catheter-Related Bloodstream Infection Caused by Gram-Positive Pathogens</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><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.</description><subject>Administered dose</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotics</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Bacteremia</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Catheters</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Clinical outcomes</subject><subject>Dosage</subject><subject>Drug Administration Schedule</subject><subject>Drug therapy</subject><subject>Female</subject><subject>General aspects</subject><subject>Glycopeptides</subject><subject>Human bacterial diseases</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Major Articles</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pathogens</subject><subject>Pharmacology. 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Antiinfectious agents. Antiparasitic agents</topic><topic>Bacteremia</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Catheters</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Clinical outcomes</topic><topic>Dosage</topic><topic>Drug Administration Schedule</topic><topic>Drug therapy</topic><topic>Female</topic><topic>General aspects</topic><topic>Glycopeptides</topic><topic>Human bacterial diseases</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Major Articles</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pathogens</topic><topic>Pharmacology. 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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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