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dalbavancin (Dalvance, Zeven)
Indications:
- acute gram-positive bacterial skin infections, & soft structure infections including MRSA
* unable to take &/or failed oral therapy
* size of skin lesion: > 3.5 x 3.5 in
* no hemodynamic instability or immunosuppression
* outpatient telehealth follow-up at 24 hours & 72 hours
Dosage:
- given IV on days 1 & 8
Antimicrobial activity:
- Staphylococcus aureus including MRSA
- Streptococcus
- Streptococcus pyogenes
- Streptococcus agalactiae
- Streptococcus anginosus
Adverse effects:
- nausea, headache, diarrhea
- elevations of serum transaminases
- red man syndrome
Mechanism of action:
- inhibition of bacterial cell wall formation
Notes:
- FDA advisers expressed concern about the second dose on day 8
- use in emergency department effective for reducing hospital admissions
General
antibacterial glycopeptide
aromatic compound
Database Correlations
PUBCHEM cid=23724878
References
- Young K
FDA Advisers Recommend Approval of Two Antibiotics.
Physician's First Watch, April 2, 2014
David G. Fairchild, MD, MPH, Editor-in-Chief
Massachusetts Medical Society
http://www.jwatch.org
- FDA News Release. May 23, 2013
FDA approves Dalvance to treat skin infections
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm398724.htm
- Boucher HW et al.
Once-weekly dalbavancin versus daily conventional therapy for
skin infection.
N Engl J Med 2014 Jun 5; 370:2169
PMID: 24897082
http://www.nejm.org/doi/full/10.1056/NEJMoa1310480
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015
- Walker M.
Dalbavancin Protocol in ED Effective for Skin Infections.
Use of long-acting IV lipoglycopeptide antibiotic also cut
hospital admissions.
MedPage Today. June 10, 2018
https://www.medpagetoday.com/meetingcoverage/asmmicrobe/73402
- Dubrovskaya Y et al
Collaborative interdisciplinary process for dalbavancin (DBV)
use in emergency department as an alternative to hosp. admission.
ASM Microbe 2018; Abstract Saturday 588.