Infectious Disease Compendium

Dalbavancin

Dosing

(PubMed)

CrCl Formula

CrCl > 30: 1 gram load then 500 mg every week. Yes, week. It has a very long half-life.

CrCl < 30: 750 mg followed one week later by 375 mg.

Hemodialysis:

Peritoneal dialysis:

Important side effects

None to date.

Red man syndrome.

Important drug interactions

Rants and Screeds

Dalbavancin 2 dose administration (1000 mg, followed by 500 mg in 7 days): $2,835.48 + $1,417.74 = $4,253.22. Are you kidding me? This decade has seen a resurgence in price gouging for antibiotics.

Pearls

Treatment of choice

Use for

Approved for soft tissue infections, use of which suggests to me that the prescriber doesn't know how to treat cellulitis.

All gram-positive including VRE (not great) and MRSA. Same spectrum as vancomycin, but much better mic's. Only approved for cellulitis, for which it is no worse than vancomycin (PubMed); 4–8 times more potent than vancomycin against S. aureus, the definition of damning with faint praise I suppose.

It has been used for a variety of more serious infections (endocarditis, osteomyelitis, septic thrombophlebitis, epidural infection) with fine results (PubMed)(PubMed).

Don't use for

Class

Lipoglycopeptide.

Last Update: 10/21/19.