Dalbavancin, oritavancin effective against skin infections

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Once-weekly dalbavancin, single-dose oritavancin noninferior to vancomycin in acute bacterial skin infection.

Dalbavancin, oritavancin effective against skin infections
Dalbavancin, oritavancin effective against skin infections

HealthDay News -- Two novel lipoglycopeptide antibiotics with activity against gram-positive bacteria, dalbavancin and oritavancin, are noninferior to daily vancomycin for the treatment of acute bacterial skin and skin-structure infections, according to researchers.

“Once-weekly intravenous dalbavancin was not inferior to twice-daily intravenous vancomycin followed by oral linezolid for the treatment of acute bacterial skin and skin-structure infection,” wrote Helen W. Boucher, MD, from the Tufts University School of Medicine in Boston, and colleagues. Their findings were published in the New England Journal of Medicine.

Patients with acute bacterial skin and skin-structure infection were randomly assigned dalbavancin intravenously (once weekly) or daily vancomycin intravenously followed by optional linezolid in two noninferiority trials, DISCOVER 1 and DISCOVER 2.

Investigators found that dalbavancin was noninferior in both trials. In a pooled analysis of data from both studies, 79.7% of the dalbavancin group and 79.8% of the vancomycin group had an early clinical response.

In a separate study published in the New England Journal of Medicine, G. Ralph Corey, MD, of Duke University Medical Center in Durham, N.C., and colleagues conducted a double-blind trail involving adult patients with acute bacterial skin and skin-structure infections who were randomly assigned a single dose of oritavancin (n=475 patients) or twice-daily vancomycin (n=479 patients).

The prespecified noninferiority margin of 10% for oritvancin versus vancomycin was met by all three efficacy end points: the primary composite end point, investigator-assessed clinical cure, and the proportion of patients with reduction of lesion area of 20% or more.

"A single dose of oritavancin was noninferior to twice-daily vancomycin administered for seven to 10 days for the treatment of acute bacterial skin and skin-structure infections caused by gram-positive pathogens," wrote the researchers.

References

  1. Boucher H et al. New England Journal of Medicine. 2014; doi: 10.1056/NEJMoa1310480
  2. Corey G et al. New England Journal of Medicine. 2014; doi: 10.1056/NEJMoa1310422
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