Dalbavancin for Management of Enterococcus faecalis Infection: A Word of Caution

In vitro data offer additional clues that dalbavancin might be a suboptimal choice for patients with E. faecalis endocarditis.

Increasingly, clinicians rely on off-label use of long-acting glycopeptide agents like dalbavancin to streamline outpatient parenteral antibiotic therapy against a range of invasive gram-positive infections encompassing bacteremia, endocarditis, and osteomyelitis. However, because supporting clinical evidence is lacking beyond the ongoing Dalbavancin Option to Treat S. aureus (DOTS) trial, Luque Paz and colleagues examined the in-vitro activity of dalbavancin alone and in combination with beta-lactams against 10 clinical isolates of Enterococcus faecalis.

While synergy occurred between dalbavancin and beta-lactams below minimum inhibitory concentrations (MIC), time-kill assays at or above MIC revealed antagonism between dalbavancin and amoxi…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases