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New Agents Found Noninferior to Vancomycin for Skin Infection

Once-weekly dalbavancin, single-dose oritavancin noninferior to vancomycin in acute bacterial skin ix

THURSDAY, June 5, 2014 (HealthDay News) -- Two lipoglycopeptide agents that are active against gram-positive bacteria, dalbavancin and oritavancin, are noninferior to daily vancomycin for the treatment of acute bacterial skin and skin-structure infections, according to two studies published in the June 5 issue of the New England Journal of Medicine.

Helen W. Boucher, M.D., from the Tufts University School of Medicine in Boston, and colleagues randomized patients with acute bacterial skin and skin-structure infection to receive dalbavancin intravenously (once weekly) or daily vancomycin intravenously followed by optional linezolid in two noninferiority trials, DISCOVER 1 and DISCOVER 2. The researchers found that dalbavancin was noninferior in both DISCOVER 1 and DISCOVER 2. In the pooled analysis, 79.7 percent of the dalbavancin group and 79.8 percent of the vancomycin-linezolid group had an early clinical response.

G. Ralph Corey, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues conducted a double-blind trial involving adults with acute bacterial skin and skin-structure infections who were randomized to a single dose of oritavancin (475 patients) or twice-daily vancomycin (479 patients). The researchers found that the prespecified noninferiority margin of 10 percent for oritavancin versus vancomycin was met by all three efficacy end points: the primary composite end point, investigator-assessed clinical cure, and the proportion of patients with reduction of lesion area of 20 percent or more.

"A single dose of oritavancin was noninferior to twice-daily vancomycin administered for seven to 10 days for the treatment of acute bacterial skin and skin-structure infections caused by gram-positive pathogens," Corey and colleagues write.

Several authors from the Boucher study disclosed financial ties to pharmaceutical companies, including Durata Therapeutics, which funded the study. The Corey study was supported by the Medicines Company.

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