Systematic review and meta-analysis on the safety of dalbavancin

BACKGROUND: Dalbavancin is a semisynthetic lipoglycopeptide antimicrobial agent with activity against Gram-positive bacteria including anaerobes. RESEARCH DESIGN AND METHODS: Meta-analysis of randomized control trials and large case series (more than 20 patients), were identified by searching Pubmed and Cochrane databases through 14 December 2020. RESULTS: 3,073 patients from 6 RCTs met the inclusion criteria. Treatment emergent adverse effects were described in 30.6% dalbavancin patients, and 38.1% patients with other treatments. Our meta-analysis supports favorable results for dalbavancin treatment (OR 0.79; 95%CI 0.66-0.94; p = 0.01). 2.74% dalbavancin patients had to discontinue treatment versus 2.49% patients on other antibiotics. 4.80% dalbavancin patients versus 5.30% patients with other treatments had severe adverse events. 0.31% in the dalbavancin group and 0.95% receiving other antibiotics died. There was no statistically significant difference in severe adverse effects with OR 0.77; 95% CI 0.52-1.14; p = 0.19. Dalbavancin therapy was shown to have statistically significant lower mortality rate (OR 0.26; 95% CI 0.07-0.90; p = 0.03). Observational studies reported few side effects but included a heterogeneous population of patients concerning their diagnosis and the duration of antibiotic treatment. CONCLUSIONS: Dalbavancin has comparable safety profile relative to other antibiotics and is well-tolerated.