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Pathway Description
Dalbavancin Action Pathway
Staphylococcus aureus
Category:
Metabolite Pathway
Sub-Category:
Drug Action
Created: 2023-02-13
Last Updated: 2025-05-31
Dalbavancin is an antibacterial used to treat acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible strains of Gram-positive bacteria.
Dalbavancin is a second-generation lipoglycopeptide antibiotic that was designed to improve on the natural glycopeptides currently available, such as vancomycin and teicoplanin. Dalbavancin has a spectrum and mechanism of action similar to vancomycin, a naturally formed glycopeptide antimicrobial. The bactericidal action of dalbavancin results primarily from inhibition of cell-wall biosynthesis. Specifically, dalbavancin prevents incorporation of N-acetylmuramic acid (NAM)- and N-acetylglucosamine (NAG)-peptide subunits from being incorporated into the peptidoglycan matrix; which forms the major structural component of Gram-positive cell walls. The large hydrophilic molecule is able to form hydrogen bond interactions with the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides, which is normally a five-point interaction. Binding of dalbavancin to the D-Ala-D-Ala prevents the incorporation of the NAM/NAG-peptide subunits into the peptidoglycan matrix. In addition, dalbavancin alters bacterial-cell-membrane permeability and RNA synthesis. Dalbavancin for injection is indicated for the treatment of adult patients with ABSSSI, caused by susceptible isolates of the following gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (including Streptococcus anginosus, Streptococcus intermedius, Streptococcus constellatus) and Enterococcus faecalis (vancomycin susceptible strains). Dalbavancin is not active against gram-negative bacteria.
References
Dalbavancin Pathway References
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Safrin S (2017). Antiviral agents. Katzung B.G.(Ed.), Basic & Clinical Pharmacology, 14e. McGraw-Hill. https://accessmedicine-mhmedical-com.login.ezproxy.library.ualberta.ca/content.aspx?bookid=2249§ionid=175223510
Bailey J, Summers KM: Dalbavancin: a new lipoglycopeptide antibiotic. Am J Health Syst Pharm. 2008 Apr 1;65(7):599-610. doi: 10.2146/ajhp070255.
Pubmed: 18359966
Bennett JW, Lewis JS, Ellis MW: Dalbavancin in the treatment of complicated skin and soft-tissue infections: a review. Ther Clin Risk Manag. 2008 Feb;4(1):31-40. doi: 10.2147/tcrm.s46.
Pubmed: 18728718
Leuthner KD, Yuen A, Mao Y, Rahbar A: Dalbavancin (BI-387) for the treatment of complicated skin and skin structure infection. Expert Rev Anti Infect Ther. 2015 Feb;13(2):149-59. doi: 10.1586/14787210.2015.995633.
Pubmed: 25578881
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