Dalbavancin
- This edition of the Bulletin is about a newer antibiotic Dalbavancin, and its action against bacterial infections.
- Dalbavancin is a long-acting second-generation lipoglycopeptide antibiotic with activity against most gram-positive bacteria, with excellent tissue and bone penetration, It was initially approved by the Food and Drug Administration for treatment of acute bacterial skin and soft tissue infections. Since then, Dalbavancin’s role has expanded to off-label indications such as bone and articular infections, endocarditis, and bacteremia
- Dalbavancin is used for confirmed or suspected infections caused by gram-positive organisms which are resistant to first line antibiotics.
Expected side effects
| Gastrointestinal disorders | Abdominal pain, Gastrointestinal Hemorrhage |
| General disorders and administration site conditions | Infusion-related reactions |
| Hepatobiliary disorders | Hepatotoxicity |
| Immune system disorders | Anaphylactic reaction |
| Metabolism and nutrition disorders | Hypoglycemia |
| Nervous system disorders | Dizziness |
| Skin and subcutaneous tissue disorders | Rash, urticarial |
| Investigations | Blood alkaline phosphatase increased |
Discussion
- Dalbavancin inhibits bacterial cell wall biosynthesis, disrupts the bacterial cell wall, leading to cell death
- Recent outcome studies have demonstrated that a Gram-positive infection may increase the hospital length of stay from 7 to 28 days.
- Treatment with dalbavancin simplifies the antibiotic regimen and allows for early discharge from the hospital and reduction in hospital length of stay.
- For complicated soft tissue infections, osteomyelitis, and spinal infections, the cure rate was 91%
- Dalbavancin is not cost-effective or affordable for most patients, with the current market price ranging from ₹18,000 to ₹33,000 per vial, respectively
- In patients treated with dalbavancin, serious hypersensitivity and skin reactions have been reported.
