Drug reference
Dalbavancin is a glycopeptide antibacterial; it has bactericidal activity against Gram-positive bacteria including various staphylococci. However, there are reports of Staphylococcus aureus with reduced susceptibility to glycopeptides and increasing reports of glycopeptide-resistant enterococci.
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Acute bacterial skin and skin structure infections ▶BY INTRAVENOUS INFUSION ▶Adult: 1500 mg for 1 dose, alternatively 1000 mg, then 500 mg after 1 week
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Manufacturer advises use with caution in patients with other glycopeptide sensitivity.
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Scottish Medicines Consortium (SMC) decisions SMC No. 1105/15 The Scottish Medicines Consortium has advised (January 2017) that dalbavancin (Xydalba ®) is accepted for restricted use within NHS Scotland for the treatment of acute bacterial skin and skin structure infections (ABSSSI), only if: . used as second-line treatment, or . meticillin-resistant Staphylococcus aureus infection is suspected, or . under local microbiologist or infectious diseases specialist advice; and . the patient is initially hospitalised due to ABSSSI requiring intravenous antibiotics but is eligible for early discharge as soon as their medical condition does not require further inpatient treatment. All Wales Medicines Strategy Group (AWMSG) decisions AWMSG No. 2001 The All Wales Medicines Strategy Group has advised (July 2018) that dalbavancin (Xydalba ®) is recommended as an option for restricted use within NHS Wales for the treatment of acute bacterial skin and skin structure infections (ABSSSI) in adults: . as a second-line treatment of ABSSSI, or . when meticillin-resistant Staphylococcus aureus (MRSA) infection is suspected, or . on the advice of local microbiologists or infectious disease specialists, and . the patient is at first hospitalised due to ABSSSI and needs intravenous antibiotics but is allowed early discharge as they don’t need further inpatient treatment.
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▶Common or very common Diarrhoea. headache. nausea ▶Uncommon Anaemia. antibiotic associated colitis. appetite decreased. constipation. cough. dizziness. eosinophilia. flushing. gastrointestinal discomfort. increased risk of infection. infusion related reaction. insomnia. leucopenia. neutropenia. skin reactions. taste altered. thrombocytosis. vomiting. vulvovaginal pruritus ▶Rare or very rare Bronchospasm ▶Frequency not known Ototoxicity
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Dose adjustments Manufacturer advises avoid unless essential—toxicity in animal studies.
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Dose adjustments Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises caution in moderate to severe impairment (no information available).
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Dose adjustments Manufacturer advises reduce dose to 1000 mg as a single infusion or reduce dose to 750 mg followed one week later by 375 mg if creatinine clearance <30 mL/minute.
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Manufacturer advises for intravenous infusion (Xydalba ®), reconstitute each 500 mg vial to produce a 20 mg/mL solution with 25 mL water for injections. Dilute reconstituted solution to a concentration of 1–5 mg/mL with Glucose 5%; give intermittently over 30 minutes (avoid rapid infusion—risk of ’red man’ syndrome).
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ▶Xydalba (Correvio UK Ltd) Dalbavancin (as Dalbavancin hydrochloride) 500 mg Xydalba 500mg powder for concentrate for solution for infusion vials | 1 vial P £558.70 (Hospital only)
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1500 mg for 1 dose, alternatively 1000 mg, then
First-line fragment. Read the complete Indications and Dose section above.
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