Abstract:

Objectives: In the present meta-analysis, we aimed to assess the clinical efficacy and safety of dalbavancin and compare it with commonly used anti-Gram-positive bacterial treatment.

Methods: The Pubmed, Embase, and Cochrane Library databases were searched from their inception up to 25 February 2020. Randomized controlled trials (RCTs) comparing the efficacy and safety of dalbavancin with other antibiotics against Gram-positive bacterial infections were included. Studies were excluded if they were reviews, conference abstracts, editorials, case reports, studies on healthy people, or those lacking a comparator group or focusing on different dosages.

Results: Seven RCTs consisting of 2,665 patients were included. Five RCTs included 2,109 patients with skin and skin structure infections (SSSIs), while the other two RCTs included patients with catheter-related bloodstream infections (CRBSIs) and osteomyelitis, respectively. The clinical and microbiological responses of the dalbavancin were similar to other antibiotics in treating infections caused by Gram-positive bacteria, including the SSSI subgroup. The clinical response of dalbavancin showed superiority in the CRBSI and osteomyelitis subgroups. No significant difference was observed between dalbavancin and other treatments in terms of adverse events (AEs), adverse drug reactions (ADRs), and serious AEs. However, the single-dose regimen had significantly more AEs compared with the comparator group, while the dual-dose regimen resulted in fewer AEs and ADRs as well as a lower incidence of diarrhea compared with the comparator group. Moreover, the dalbavancin group showed a decreased risk of mortality compared with the other treatments.

Conclusions: Dalbavancin was comparable to other antibiotics in treating chronic Gram-positive bacterial infections in terms of efficacy and safety. The dual-dose regimen showed a better safety profile compared with the single-dose regimen in the treatment of skin infections.

Reference:

Wang Y, Wang J, Wang R, Li Y, Cai Y. Efficacy and Safety of Dalbavancin in Treatment of Gram-positive Bacterial Infections. J Glob Antimicrob Resist. 2020 Dec 3:S2213-7165(20)30304-0. doi: 10.1016/j.jgar.2020.11.018. Epub ahead of print. PMID: 33279683.