Center of Medicine Clinical Research, Department of Pharmacy, PLA General Hospital, Beijing, China.
J Glob Antimicrob Resist. 2021 Mar;24:72-80. doi: 10.1016/j.jgar.2020.11.018. Epub 2020 Dec 3.
In this meta-analysis, we assessed the clinical efficacy and safety of dalbavancin compared with commonly used anti-Gram-positive agents.
PubMed, Embase and Cochrane Library databases were searched from inception up to 25 February 2020. Randomised controlled trials (RCTs) comparing the efficacy and safety of dalbavancin with other antibiotics against Gram-positive infections were included. Reviews, conference abstracts, editorials, case reports, studies on healthy people, or those lacking a comparator group or focusing on different dosages were excluded.
Seven RCTs comprising 2665 patients were included. Five RCTs included 2109 patients with skin and skin-structure infections (SSSIs) and the other two included patients with catheter-related bloodstream infections (CRBSIs) and osteomyelitis, respectively. Clinical and microbiological responses to dalbavancin were similar to other antibiotics in treating infections caused by Gram-positive bacteria, including the SSSI subgroup. Clinical response to dalbavancin showed superiority in the CRBSI and osteomyelitis subgroups. No significant difference was observed between dalbavancin and other treatments in terms of adverse events (AEs), adverse drug reactions (ADRs) and serious AEs. However, the single-dose regimen had significantly more AEs compared with the comparator group, while the dual-dose regimen resulted in fewer AEs and ADRs and a lower incidence of diarrhoea compared with the comparator group. Moreover, the dalbavancin group showed a decreased mortality risk compared with other treatments.
Dalbavancin was comparable with other antibiotics in treating chronic Gram-positive infections in terms of efficacy and safety. The dual-dose regimen showed a better safety profile compared with the single-dose regimen in the treatment of SSSIs.
本荟萃分析评估了达巴万星与常用抗革兰阳性菌药物相比的临床疗效和安全性。
检索了 PubMed、Embase 和 Cochrane Library 数据库，检索时间截至 2020 年 2 月 25 日。纳入比较达巴万星与其他抗生素治疗革兰阳性感染的疗效和安全性的随机对照试验（RCT）。排除综述、会议摘要、社论、病例报告、在健康人群中进行的研究、缺乏对照组或关注不同剂量的研究。
纳入了 7 项 RCT，共 2665 例患者。5 项 RCT 纳入了 2109 例皮肤和皮肤结构感染（SSSI）患者，另外 2 项 RCT 分别纳入了导管相关血流感染（CRBSI）和骨髓炎患者。达巴万星治疗革兰阳性菌感染的临床和微生物学反应与其他抗生素相似，包括 SSSI 亚组。达巴万星在 CRBSI 和骨髓炎亚组的临床反应具有优势。达巴万星与其他治疗方法在不良事件（AE）、药物不良反应（ADR）和严重 AE 方面无显著差异。然而，单剂量方案与对照组相比，AE 发生率更高，而双剂量方案与对照组相比，AE 和 ADR 发生率更低，腹泻发生率更低。此外，与其他治疗方法相比，达巴万星组的死亡率降低。
达巴万星在治疗慢性革兰阳性感染的疗效和安全性方面与其他抗生素相当。与单剂量方案相比，双剂量方案在治疗 SSSI 方面具有更好的安全性。
