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1 February 2005

Volume 40, Number 3
Clinical Infectious Diseases 2005;40:374–380
© 2005 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2005/4003-0005$15.00
DOI: 10.1086/427283
MAJOR ARTICLE

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

Issam Raad,1

Rabih Darouiche,2

Jose Vazquez,3

Arnold Lentnek,4

Ray Hachem,1

Hend Hanna,1

Beth Goldstein,5

Tim Henkel,5 and

Elyse Seltzer5

1The M. D. Anderson Cancer Center and 2Veterans Affairs Medical Center, Houston, Texas; 3Harper University Hospital, Detroit, Michigan; 4Wellstar/Kennestone Hospital, Marietta, Georgia; and 5Vicuron Pharmaceuticals, King of Prussia, Pennsylvania

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 ( ) 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 ( ) (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.

Received 22 June 2004; accepted 22 September 2004; electronically published 7 January 2005.

Reprints or correspondence: Dr. Elyse Seltzer, 455 South Gulph Rd., Ste. 310, King of Prussia, PA 19406 ().

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