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The following is a summary of “Dalbavancin sequential therapy for Gram-Positive bloodstream infection: A multicenter observational study,” published in March 2024 issue of Infectious Disease by Rebold et al. 

Long-acting lipoglycopeptides, like dalbavancin, can potentially treat gram-positive bloodstream infections (BSI) in patients facing discharge challenges or requiring extended intravenous antibiotics.

Researchers conducted a retrospective study to provide multicenter real-world evidence on dalbavancin’s efficacy as sequential therapy for gram-positive BSI.

They involved 115 patients from 13 centers across the US (2015-2021) receiving dalbavancin for gram-positive BSI (positive blood cultures or diagnosed endocarditis).

The result showed that patients with a mean (SD) age of 48.5 (17.5) years were predominantly male (54%), of whom 40% injected drugs. Primary sources of infection included BSI (89%), skin infections (25%), endocarditis (19%), and bone/joint infections (17%). Staphylococcus aureus constituted 72% of cultures, coagulase-negative Staphylococcus 18%, and Streptococcus species 16%. Dalbavancin initiation occurred at a median (Q1–Q3) of 10 (6–19) days post-culture collection, often as a 1500 mg single dose. The primary outcome was 12.2% composite clinical failure, with 7.0% mortality and 3.5% BSI recurrence at 90 days.

Investigators concluded that dalbavancin demonstrated the potential for facilitating hospital discharge in gram-positive BSI patients. Further RCTs were warranted to confirm its efficacy as an alternative to current treatment standards.


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