Acute bacterial skin and skin structure infections in pediatric patients: potential role of dalbavancin

Expert Rev Anti Infect Ther. 2023 Apr;21(4):329-341. doi: 10.1080/14787210.2023.2182769. Epub 2023 Feb 27.

Abstract

Introduction: Acute bacterial skin and skin structure infections (ABSSSIs) are a subtype of skin and soft tissue infections (SSTI), usually sustained by Gram-positive bacteria, whose incidence is high among children. ABSSSIs are responsible for a considerable number of hospitalizations. Moreover, as multidrug resistant (MDR) pathogens become widespread, the pediatric category seems burdened with an increased risk of resistance and treatment failure.

Areas covered: To obtain a view on the status of the field, we describe the clinical, epidemiological, and microbiological aspects of ABSSSI in children. Old and new treatment options were critically revised with a focus on the pharmacological characteristics of dalbavancin. Evidence on the use of dalbavancin in children was collected, analyzed, and summarized.

Expert opinion: Many of the therapeutic options available at the moment are characterized by the need for hospitalization or repeated intravenous infusions, safety issues, possible drug-drug interactions, and reduced efficacy on MDRs. Dalbavancin, the first long-acting molecule with strong activity against methicillin-resistant and also many vancomycin-resistant pathogens represents a game changer for adult ABSSSI. In pediatric settings, the available literature is still limited, but a growing body of evidence supports dalbavancin use in children with ABSSSI, demonstrating this drug to be safe and highly efficacious.

Keywords: ABSSSI; Dalbavancin; children; long-acting antimicrobial; pediatric population.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Child
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / epidemiology
  • Humans
  • Skin Diseases, Bacterial* / drug therapy
  • Skin Diseases, Bacterial* / microbiology
  • Soft Tissue Infections* / drug therapy
  • Teicoplanin

Substances

  • dalbavancin
  • Anti-Bacterial Agents
  • Teicoplanin