Dalbavancin, a Second Generation Lipoglycopeptide is a New Addition to Therapy Armamentarium

Abstract

Gram-positive infections with widespread developing resistance have posed considerable challenges to the long stay of antimicrobials in the market. Also, there has been a dearth in the provision of a suitable antimicrobial to treat the evolving resistance. Dalbavancin a 2nd generation lipoglycopeptide has shown its activity against gram-positive and multidrug resistant isolates. Owing to a favorable pharmacokinetic profile and supporting evidence this drug moiety has been used as long-term therapy for various indications. These indications include infective endocarditis (IE), osteomyelitis, bloodstream infections, and prosthetic joint infections. However, it is approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) only for acute bacterial skin and skin structure infections (ABSSSIs). Dalbavancin can be a valuable alternative to daily in-hospital intravenous or outpatient antimicrobial regimens in the treatment of long-term Gram-positive infections and ‘niche’ but important indications. This systematic review demonstrates comparative microbiology, chemistry, in vitro susceptibility, pharmacokinetics, clinical efficacy, safety, tolerability, dosage, and administration of dalbavancin. Additionally, it highlights past, present, and upcoming evidence of real-world use of dalbavancin alone or in combination with different indications. Keywords: Dalbavancin, Acute bacterial skin and skin structure infections, Gram-positive, Long-term, and pharmacokinetics.