Dalbavancin intravenous infusion for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Red light antimicrobial- requires Micro/ID pre-approval
  • Not routinely kept in stock- ordered on the instruction of Micro/ID only (ref 1)
  • See under Dose for adjustments required in Renal impairment
  • Caution if known hypersensitivity to other glycopeptides as cross-sensitivity may occur
  • Note: rapid administration can cause reactions including flushing of the upper body, urticaria, pruritis and/or rash. Stopping or slowing the infusion may result in cessation of these reactions

Available preparations

Xydalba 500mg vial (Europe)

Reconstitution

Water for injection

25mL per 500mg vial

  • Do NOT shake. To avoid foaming alternate between gently swirling and inverting the vial until the powder is dissolved
  • Reconstitution time may be up to 5 minutes
  • Dilute further prior to administration

Infusion fluids

Glucose 5% ONLY

If giving other drugs via the same line, the line must be flushed before and after each dalbavancin infusion with Glucose 5%

Methods of intravenous administration

Intermittent intravenous infusion

  • Add required dose to a suitable volume of infusion fluid to give a final concentration of 1mg/mL to 5mg/mL and administer over 30 minutes
Required Dose Volume of reconstituted solution Suggested volume of infusion fluid bag
1.5g (1500mg) 75mL add 75mL to 250mL bag* see below
1g (1000mg) 50mL 250mL
750mg 37.5mL 250mL
500mg 25mL 100mL or 250mL
375mg 18.75mL 100mL or 250mL
* a 1.5g dose may be added to any volume between 225mL and 1425mL (to give a concentration of 1 to 5mg/mL) so addition to a 250mL bag has been suggested

Dose in adults

Usual dose

Skin and soft tissue infection (licensed indication)

  • Give 1.5g (1500mg) as a single dose OR
  • Give 1g (1000mg) followed one week later by 500mg

Other infections:

  • Alternative dosing regimens may be used if recommended for off-label use in other types of infection by a Microbiology or Infectious Diseases consultant

Renal impairment

  • CrCl less than 30 ml/minute (not on regular haemodialysis)

    • Give 1g (1000mg) as a single dose OR
    • Give 750mg followed one week later by 375mg
  • On regular intermittent haemodialysis (three times per week):
    • Dose adjustment not required

Hepatic impairment

  • Caution in moderate or severe hepatic impairment (Child-Pugh B & C)- no data available to guide dosing

Storage

  • Store below 250C

References

SPC Xydalba 10/2020

1: Email on file from Antimicrobial Stewardship team, 21st Feb 2019

2: Email on file- now a red light antimicrobial- June 2022

Therapeutic classification

Lipoglycopeptide