Pharmacokinetics of Dalbavancin in Complicated Bacteremia

What are the pharmacokinetics of a 2-dose dalbavancin regimen used for consolidation therapy in complicated bacteremia, and is dalbavancin exposure associated with clinical success?In this prespecified secondary analysis that included 97 adults with complicated bacteremia from a randomized clinical trial, kidney function, weight, albumin level, and age influenced dalbavancin pharmacokinetics. Total day 22 concentrations greater than 32 μg/mL were associated with increased rates of day 70 clinical success, without corresponding increases in serious adverse events.Although 2 doses of dalbavancin were noninferior to standard therapy in complicated bacteremia in the parent trial, these findings suggest that future studies should assess whether patients with day 22 concentrations of 32 μg/mL or less may benefit from an additional dose.

Corresponding Author: Thomas L. Holland, MD, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, DUMC 102359, Durham, NC 27710 (thomas.holland@duke.edu).

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