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Peptide

Dalbavancin (Dalvance)

Dalbavancin is a second-generation lipoglycopeptide antibiotic for acute bacterial skin infections. FDA-approved May 2014. Once-weekly or single-dose therapy: 1500 mg single dose OR 1000 mg + 500 mg at 1 week. DISCOVER-1 & DISCOVER-2 Phase 3: Noninferior to vancomycin/linezolid 14-day course (79.7% vs 79.8%). Half-life >1 week enables weekly dosing. Coverage: MRSA (MIC <0.125 µg/mL), MSSA, Streptococci. Pediatric approval 2021 (birth and older). First single-dose complete ABSSSI treatment.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
6
Graded outcomes
4200

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Skin and Soft Tissue Infections

Skin and Soft Tissue Infections: outcomes studied for Dalbavancin (Dalvance)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Clinical Cure Rate

DISCOVER-1 & DISCOVER-2 pooled (n=1289): Clinical success 79.7% dalbavancin vs 79.8% vancomycin/linezolid (noninferior). Two-dose regimen: 1000 mg day 1, 500 mg day 8. Single-dose 1500 mg also approved. NCT01339091, NCT01431339.

NoneNo effect24 studies

Studies that measured clinical cure rate

and 14 more in the citations list

Early Clinical Response (48-72h)

≥20% reduction in lesion area at 48-72h: 83.3% dalbavancin vs 81.8% comparator. Met FDA-required early clinical response endpoint. Among first trials to use new early primary efficacy endpoints.

NoneNo effect16 studies

Studies that measured early clinical response (48-72h)

and 6 more in the citations list

MRSA Efficacy

MRSA clinical success comparable to comparator. MIC consistently <0.125 µg/mL against MRSA. Bactericidal against VISA. No cross-resistance with other antibiotic classes.

NoneNo effect16 studies

Studies that measured mrsa efficacy

and 6 more in the citations list

Nephrotoxicity vs Vancomycin

Post-hoc safety analysis: Lower nephrotoxicity rates compared to vancomycin. No renal dose adjustment required for CrCl >30 mL/min. Less monitoring required than vancomycin due to weekly dosing and predictable PK.

Improves (the measure goes down)Moderate effect15 studies

Studies that measured nephrotoxicity vs vancomycin

and 5 more in the citations list

General

General: outcomes studied for Dalbavancin (Dalvance)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

12 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect24 studies

Studies that measured antimicrobial activity

and 14 more in the citations list

Safety/Tolerability

7 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Small effect21 studies

Studies that measured safety/tolerability

and 11 more in the citations list

Key findings

  • Clinical Cure RateSkin and Soft Tissue Infections
  • Early Clinical Response (48-72h)Skin and Soft Tissue Infections
  • MRSA EfficacySkin and Soft Tissue Infections

Studies cited

43 studies from PubMed

  1. Dalbavancin for the treatment of bone and joint infections: A meta-analysis.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2025 · PMID 39029624
  2. A systematic review of dalbavancin efficacy as a sequential therapy for infective endocarditis.Infection, 2025 · PMID 39325353
  3. Safety and Efficacy of Dalbavancin in Real Life: Retrospective Analysis of a Large Monocentric Case Series of Patients Treated for Skin/Soft Tissue and Other Difficult-to-Treat Infections.Antibiotics (Basel, Switzerland), 2024 · PMID 39596758
  4. Dalbavancin as long-term treatment in Corynebacterium striatum Infections: a literature review.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2024 · PMID 38533780
  5. Dalbavancin as suppressive therapy for implant-related infections: a case series with therapeutic drug monitoring and review of the literature.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024 · PMID 38753112
  6. Dalbavancin as suppressive antibiotic therapy in patients with prosthetic infections: efficacy and safety.Frontiers in pharmacology, 2023 · PMID 37448966
  7. Dalbavancin as sequential therapy for infective endocarditis due to Gram-positive organisms: a review.International journal of antimicrobial agents, 2023 · PMID 36758775
  8. The current and future off-label uses of dalbavancin: a narrative review.European review for medical and pharmacological sciences, 2023 · PMID 36808371
  9. Expert Opinion on Dose Regimen and Therapeutic Drug Monitoring for Long-Term Use of Dalbavancin: Expert Review Panel.International journal of antimicrobial agents, 2023 · PMID 37633424
  10. A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections.Antibiotics (Basel, Switzerland), 2023 · PMID 37887193
  11. Acute Bacterial Skin and Skin-Structure Infections, efficacy of Dalbavancin: a systematic review and meta-analysis.Expert review of anti-infective therapy, 2022 · PMID 32981375
  12. Dalbavancin treatment for spondylodiscitis: multi-center clinical experience and literature review.Journal of chemotherapy (Florence, Italy), 2022 · PMID 34923922
  13. Dalbavancin as an option for treatment of S. aureus bacteremia (DOTS): study protocol for a phase 2b, multicenter, randomized, open-label clinical trial.Trials, 2022 · PMID 35578360
  14. Safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSI): nephrotoxicity rates compared with vancomycin: a post hoc analysis of three clinical trialsTher Adv Infect Dis, 2021 · PMID 33515414
  15. Stewarding the Costly Antibiotic: Considerations for Dalbavancin.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 · PMID 33211844
  16. Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs.Drug design, development and therapy, 2021 · PMID 34376971
  17. Efficacy and safety of dalbavancin in the treatment of Gram-positive bacterial infections.Journal of global antimicrobial resistance, 2021 · PMID 33279683
  18. Review: A Safety Profile of Dalbavancin for On- and Off-Label Utilization.Therapeutics and clinical risk management, 2021 · PMID 33790563
  19. Systematic review and meta-analysis on the safety of dalbavancin.Expert opinion on drug safety, 2021 · PMID 34042549
  20. Dalbavancin treatment for prosthetic joint infections in real-life: a national cohort study and literature review.Journal of global antimicrobial resistance, 2021 · PMID 33962065
  21. Multiple-Dose Dalbavancin Regimens as the Predominant Treatment of Deep-Seated or Endovascular Infections: A Scoping Review.Open forum infectious diseases, 2021 · PMID 34738025
  22. Single-dose dalbavancin for acute bacterial skin and skin structure infectionsClin Infect Dis, 2020 · PMID 31181406
  23. Dalbavancin and telavancin in the treatment of infective endocarditis: a literature review.International journal of antimicrobial agents, 2020 · PMID 32629114
  24. Dalbavancin versus standard-of-care for the treatment of osteomyelitis associated with modular mega-prostheses infection: a multicenter prospective randomized studyJ Antimicrob Chemother, 2019 · PMID 30861387
  25. Dalbavancin for the Treatment of Osteomyelitis in Adult Patients: A Randomized Clinical Trial of Efficacy and Safety.Open forum infectious diseases, 2019 · PMID 30648126
  26. Dalbavancin as a cost effective antibiotic.Infectious diseases (London, England), 2018 · PMID 28805474
  27. Antibiotics.Nursing, 2017 · PMID 28225406
  28. Review of the pharmacokinetics of dalbavancin, a recently approved lipoglycopeptide antibiotic.Infectious diseases (London, England), 2017 · PMID 28264598
  29. Single-Dose Dalbavancin: A Review in Acute Bacterial Skin and Skin Structure Infections.Drugs, 2017 · PMID 27988870
  30. Safety of Dalbavancin in the Treatment of Skin and Skin Structure Infections: A Pooled Analysis of Randomized, Comparative Studies.Drug safety, 2016 · PMID 26715497
  31. Dalbavancin: a review in acute bacterial skin and skin structure infectionsDrugs, 2015 · PMID 26105117
  32. Dalbavancin for the treatment of acute bacterial skin and skin structure infectionsExpert Opin Pharmacother, 2015 · PMID 26239321
  33. Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI)Drugs Today (Barc), 2015 · PMID 26334674
  34. Dalbavancin: a novel lipoglycopeptide antibiotic with extended activity against gram-positive infectionsInfect Dis Clin Pract (Baltim Md), 2015 · PMID 26391571
  35. Once-weekly dalbavancin versus daily conventional therapy for skin infectionN Engl J Med, 2014 · PMID 24897082
  36. Dalbavancin: a novel once-weekly lipoglycopeptide antibiotic.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2008 · PMID 18199045
  37. Dalbavancin: a new lipoglycopeptide antibiotic.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2008 · PMID 18359966
  38. Dalbavancin: a lipoglycopeptide antibacterial for Gram-positive infections.Expert opinion on pharmacotherapy, 2008 · PMID 18570607
  39. Dalbavancin: a novel antimicrobial.International journal of clinical practice, 2007 · PMID 17362476
  40. Review of dalbavancin, a novel semisynthetic lipoglycopeptide.Expert opinion on investigational drugs, 2007 · PMID 17461743
  41. Dalbavancin: a review.Drugs of today (Barcelona, Spain : 1998), 2007 · PMID 17724497
  42. Dalbavancin: a novel lipoglycopeptide antibacterial.Pharmacotherapy, 2006 · PMID 16803423
  43. Dalbavancin: a review for dermatologists.Dermatology online journal, 2006 · PMID 17083861