Dalbavancin safe, effective in paediatric Gram-positive infections

Consolidation treatment with dalbavancin appears safe and effective for the treatment of severe infections caused by Gram-positive microorganisms in children, suggests a study.

A team of investigators conducted this retrospective study to describe the use of dalbavancin in children aged <18 years who were admitted to three referral university hospitals in Spain until 30 June 2024.

Of the 15 patients (median age 7.1 years) included, 66 percent were male. Endocarditis (26 percent) was the most common infection, followed by endovascular infections (20 percent), with Staphylococcus aureus (60 percent) being the most frequently isolated microorganism.

The use of dalbavancin was primarily for consolidation treatment (100 percent) to facilitate earlier hospital discharge (73.3 percent).

Dalbavancin was administered in one-dose regimen in eight children (53.3 percent), in two-dose regimen in five patients (30 percent), and in multiple-dose regimen in two individuals (13.3 percent). One patient developed macular rash and diarrhoea, leading to discontinuation.

At day 90, 14 patients (93 percent) were cured of infection.

“Studies in the paediatric population to assess the use of dalbavancin in children are needed. A better understanding of the pharmacokinetics of dalbavancin in multiple-dose regimens is of special interest,” the investigators said.

“There is a growing interest in the use of dalbavancin as treatment for infections caused by Gram-positive microorganisms. Due to its long half-life, linear pharmacokinetics and good tolerability, it has been used in different clinical scenarios, including off-label indications,” they noted.