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Dalbavancin for the Treatment of Acute Bacterial Skin and Skin Structure Infection in Patients with Obesity or Diabetes: A Subgroup Analysis of Pooled Phase 3 Clinical Trials

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We assessed the efficacy and safety of dalbavancin, a long-acting lipoglycopeptide with activity against gram-positive pathogens, for treatment of acute bacterial skin and skin structure infections (ABSSSI) in patients with… Click to show full abstract

We assessed the efficacy and safety of dalbavancin, a long-acting lipoglycopeptide with activity against gram-positive pathogens, for treatment of acute bacterial skin and skin structure infections (ABSSSI) in patients with high body mass index (BMI) and/or diabetes. Data from 2 phase 3 trials of dalbavancin (1000 mg intravenous [IV], day 1; 500 mg IV, day 8) versus comparator, and 1 phase 3b trial of single-dose (1500 mg IV, day 1) versus 2-dose (1000 mg IV, day 1; 500 mg IV, day 8) dalbavancin in adults with ABSSSI were pooled and summarized separately by baseline BMI and diabetes status. Clinical success at 48 to 72 hours (≥20% reduction in lesion size), end of treatment (EOT; day 14), and day 28 was evaluated in the intent-to-treat (ITT) and microITT populations. Safety data were reported in patients who received ≥1 dose of study drug. In the dalbavancin ITT population (BMI, n = 2001; diabetes, n = 2010), at 48 to 72 hours (and EOT) clinical success was achieved in 89.3% (EOT, 90.9%) of patients with normal BMI and 78.9% to 87.6% (EOT, 91.0% to 95.2%) of patients with elevated BMI. Clinical success after dalbavancin treatment was achieved in 82.4% (EOT, 90.8%) of patients with diabetes and 86.0% (EOT, 91.6%) of patients without diabetes. Similar trends were observed for infections due to MRSA or MSSA (microITT population). Dalbavancin is effective, with sustained clinical success rates in patients with obesity or diabetes, with a similar safety profile across patient groups. NCT01339091, NCT01431339, NCT02127970.

Keywords: acute bacterial; day; skin; bacterial skin; treatment acute

Journal Title: Open Forum Infectious Diseases
Year Published: 2023

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