NEW YORK (Reuters Health) - The antibiotic dalbavancin administered weekly may be more successful than twice-daily treatment with vancomycin in resolving catheter-related bloodstream infections (CR-BSIs) caused by Gram-positive pathogens, results of an open-label, phase II clinical trial suggest.
Dalbavancin is a new, semisynthetic lipoglycopeptide antibiotic with excellent activity against Gram-positive bacteria (see Reuters Health report, April 15, 2004) and with a half-life of up to 12 days.
Dr. Elyse Seltzer, with Vicuron Pharmaceuticals in King of Prussia, Pennsylvania, and colleagues randomly assigned patients with CR-BSIs to treatment with dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, or intravenous vancomycin 1000 mg b.i.d. Included in the analysis were 23 patients in the dalbavancin group and 28 in the vancomycin group.
According to their report in the February 1st issue of Clinical Infectious Diseases, the organisms involved were Staphylococcus aureus, including methicillin-resistant S. aureus; coagulase-negative staphylococci; and Enterococcus faecalis.
The overall success rate, assessed within 18 to 24 days after end of therapy, was 87% in the dalbavancin group and 50% in the vancomycin group (p < 0.05).
The number of patients in each arm reporting adverse events was similar; events tended to be mild or moderate. One patient treated with vancomycin experienced acute renal failure that was possibly related to treatment. There were no serious adverse events ascribed to dalbavancin.
These findings suggest “advantages in cost of therapy and may offer invaluable flexibility in implementing innovative approaches to antibiotic treatment of adult patients with bacteremia,” Dr. Seltzer’s group indicates. They note that weekly dosing with dalbavancin may reduce the need for indwelling catheters.
Source: Clin Infect Dis 2005;40;374-380. [ Google search on this article ]
MeSH Headings:Clinical Trials: Environment and Public Health: Epidemiologic Methods: Evaluation Studies: Health: Health Occupations: Health Services Administration: Medicine: Investigative Techniques: Population Characteristics: Preventive Medicine: Public Health: Quality of Health Care: Specialties, Medical: Drugs, Investigational: Epidemiologic Study Characteristics: Clinical Trials, Phase II: Antibiotics, Glycopeptide: Health Care Quality, Access, and Evaluation: Health Care Evaluation Mechanisms: Antibiotics, Peptide: Analytical, Diagnostic and Therapeutic Techniques and Equipment: Biological Sciences: Health CareCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
