Dalbavancin Utilization Registry Investigating Value and Efficacy (DRIVE): Outcomes in Patients With Bacteremia/Endocarditis

Introduction: – Dalbavancin has potent activity against gram-positive pathogens, including methicillin-resistant Staphylococcus aureus, and is approved for the treatment of acute bacterial skin and skin structure infections. We describe the real-world use of dalbavancin in patients with bacteremia and endocarditis. Methods: – Dalbavancin Utilization Registry Investigating Value and Effectiveness (DRIVE) was a phase 4 multicenter, observational, retrospective study of the real-world use of dalbavancin in adults across the United States. Data were collected from March 2017 to November 2018 at hospital wards, intensive care units, and outpatient parenteral antibiotic therapy units. This post hoc analysis included patients with confirmed gram-positive bloodstream infections, as well as those with clinically suspected gram-positive infections encompassing cases of bacteremia, endocarditis, or device-related infection. We assessed clinical success or failure of dalbavancin treatment according to definitions used in dalbavancin phase 3 trials. Results: – Of the 65 patients with bloodstream infection included in the safety population, 48 were evaluable (~5% of the DRIVE study population): 35 with confirmed and 13 with suspected gram-positive infection. Clinical success was achieved in 33/35 (94.3%) patients with confirmed and 10/13 (76.9%) patients with suspected gram-positive infection. Most patients (22/35 [62.9%] confirmed, 8/13 [61.5%] suspected gram-positive infection) received a single 1500 mg dose of dalbavancin. The incidence of serious adverse events was consistent with that reported in the overall DRIVE population, with no adverse events possibly related to dalbavancin. Conclusions: – In patients with confirmed or suspected gram-positive bloodstream infections, including bacteremia and/or endocarditis, dalbavancin demonstrated high rates of real-world clinical success and safety.