Treatment of acute bacterial skin and skin structure infection with single-dose dalbavancin in persons who inject drugs

Pedro Luis Gonzalez MD, MT, Urania Rappo MD, Karthik Akinapelli MS, Jennifer S McGregor RPh, Sailaja Puttagunta MD, Michael W Dunne MD

Abstract

Background: Persons who inject drugs (PWID) are at increased risk of acute bacterial skin and skin structure infections (ABSSSIs), a growing healthcare concern. Multiple medical, social, and economic issues, including adherence and comorbidities, complicate the medical care of the PWID population, adversely affecting patient outcomes.

Methods: We assessed demographics and outcomes for the PWID population in a double-blind trial of 698 patients randomized to dalbavancin 1500 mg as a single intravenous (IV) infusion or as a 2-dose regimen (1000 mg IV on day 1; 500 mg IV on day 8) for ABSSSI. The primary endpoint was ≥20% reduction in erythema at 48–72 hours in the intent-to-treat population; clinical status was also assessed at days 14 and 28.

Results: There were 212/698 (30.4%) patients with a history of injection drug use in this clinical trial. Dalbavancin efficacy was similar between the single- and 2-dose therapy groups in the PWID and non-PWID populations at all timepoints. Dalbavancin was well tolerated in the PWID population, with similar rates of adverse events as the non-PWID population.

Conclusion: Dalbavancin as a single-dose or 2-dose regimen had similar efficacy for the treatment of ABSSSI at all timepoints in the PWID and non-PWID populations. A single 30-minute IV infusion would eliminate the need for indwelling IV access. The convenience of a single dose supervised in a health setting may also optimize treatment adherence in the PWID population.

Article Details

Article Type

Original Research

DOI

10.7573/dic.212559

Categories

Publication Dates

Accepted: ; Published: .

Citation

Gonzalez PL, Rappo U, Akinapelli K, McGregor JS, Puttagunta S, Dunne MW. Treatment of acute bacterial skin and skin structure infection with single-dose dalbavancin in persons who inject drugs. Drugs in Context 2018; 7: 212559. DOI: 10.7573/dic.212559

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