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Dalbavancin, vancomycin yielded similar results for acute bacterial skin, skin-structure infection

In adults with acute bacterial skin and skin-structure infection, weekly dalbavancin was found to be noninferior to daily vancomycin, according to researchers.

The researchers conducted two replicate, randomized, controlled, noninferiority trials —DISCOVER-1 and DISCOVER-2 — at 140 sites in the U.S., Canada, Europe, South Africa and Asia. A total of 573 adults in DISCOVER-1 and 739 adults in DISCOVER-2 with acute bacterial skin and skin-structure infection (SSSI) were studied.

One treatment arm comprised treatment with intravenous dalbavancin 1g for 30 minutes on day 1 and 500 mg for 30 minutes on day 8, plus a placebo infusion every 12 hours. The second treatment arm comprised treatment with vancomycin 1 g or 15 mg/kg of body weight for 120 minutes every 12 hours for 3 days or more, with an option to switch to oral linezolid 600 mg every 12 hours. The researchers defined the primary endpoint of early clinical response as cessation of the spread of infection-related erythema and absence of fever at 48 to 72 hours.

Early clinical response was recorded in 83.3% of patients in the dalbavancin group and 81.8% of vancomycin-linezolid patients in DISCOVER-1, whereas 76.8% patients had an early clinical response within the dalbavancin group and 78.3% had an early clinical response within the vancomycin-linezolid group in DISCOVER-2.

Results of a pooled analysis showed that 79.7% of the dalbavancin group and 79.8% of the vancomycin-linezolid group achieved a successful outcome by 48 to 72 hours.

Causes of treatment failure were similar between the two treatment arms, according to the researchers.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.