dalbavancin

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Renal impairment (dose adjustment required for adults with CCr <30 mL/min and not receiving hemodialysis);
Moderate to severe hepatic impairment;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Geri: Consider age-related ↓ in renal function in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: pruritus, rash

GI: ↑liver enzymes, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), nausea

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), infusion reactions (including infusion-related reaction resembling vancomycin flushing syndrome)

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Lyophilized powder for injection: 500 mg/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 1500 mg as a single dose or 1000 mg followed 1 wk later by 500 mg.
IV (Children 6–<18 yr): CCr ≥30 mL/min/1.73 m²: 18 mg/kg (max dose = 1500 mg) as a single dose.
IV (Children Birth–<6 yr): CCr ≥30 mL/min/1.73 m²: 22.5 mg/kg (max dose = 1500 mg) as a single dose.

Renal Impairment

IV (Adults ): CCr <30 mL/min (with no hemodialysis): 1125 mg as a single dose or 750 mg followed 1 wk later by 375 mg.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to bacterial cell wall resulting in cell death.

Therapeutic effects:

Bactericidal action against susceptible bacteria with resolution of infection.

Spectrum:

Active against Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant strains), Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus (including S. anginosus, S. intermedius, and S. constellatus), Streptococcus pyogenes, and Enterococcus faecalis (only isolates susceptible to vancomycin).

Classifications ⬆ ⬇

Therapeutic Classification: anti-infectives

Pharmacologic Classification: lipoglycopeptides

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Penetrates tissues and fluids.

Metabolism/Excretion: 33% eliminated unchanged in urine, 12% eliminated as inactive metabolite, 20% excreted in feces.

Half-Life: 346 hr.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	end of infusion	1 wk

Patient/Family Teaching ⬆ ⬇

Explain purpose of dalbavancin to patient.
Instruct patient to notify health care professional if signs and symptoms of hypersensitivity reactions (rash, hives, dyspnea, facial swelling) occur.
Instruct patient to notify health care professional immediately if diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professionals
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Instruct the patient to notify health care professional if symptoms do not improve.

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Indications ⬇

Contraind./Precautions ⬆ ⬇