[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Glycopeptides](https://durgical.com/en/pharmacology/classes/glycopeptides/) › Dalbavancin [Pharmacology](https://durgical.com/en/pharmacology/) · [Glycopeptides](https://durgical.com/en/pharmacology/classes/glycopeptides/) # Dalbavancin A long-acting lipoglycopeptide for gram-positive skin infections, including MRSA, given as one or two infusions. Updated 2026-11-01 - Class: [Glycopeptides](https://durgical.com/en/pharmacology/classes/glycopeptides/) - Target: D-Ala–D-Ala terminus of the peptidoglycan precursor - ATC code: J01XA04 ◆**D-Ala–D-Ala terminus of the peptidoglycan precursor**Dalbavancin ⓘ No dalbavancin-bound structure is available; the figure shows vancomycin, its parent glycopeptide, holding the same D-Ala-D-Ala peptide. **Target in 3D:** D-Ala–D-Ala terminus of the peptidoglycan precursor. PDB structure 1FVM (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1FVM) · Drag to rotate · pinch to zoom ## Mechanism of action Dalbavancin binds the D-alanyl–D-alanine end of the stem peptide of the nascent cell wall and prevents cross-linking, like vancomycin. Its lipid side chain anchors it in the bacterial membrane and it forms dimers, which increase binding and potency. It is bactericidal against staphylococci (including MRSA) and streptococci; enterococci with the vanA gene are often resistant. - The lipid tail anchors it in the bacterial membrane - Binds the D-Ala–D-Ala end of the wall precursor - Cross-linking stops and the bacterium dies ## Pharmacokinetics **Absorption** Intravenous only. **Distribution** About 93% bound to albumin; reaches skin and bone, very little enters the cerebrospinal fluid. **Elimination** Slowly, partly unchanged in the urine and partly in the faeces. **Half-life** Very long: the effective half-life is about 8.5 days, which allows single-dose or weekly treatment. ## Indications - Acute bacterial skin and skin-structure infections by gram-positives, including MRSA. [Cellulitis of the leg →](https://durgical.com/en/conditions/cellulitis-of-the-leg/) - Skin abscesses within those infections. [Abscess, furuncle and carbuncle →](https://durgical.com/en/conditions/abscess-furuncle-and-carbuncle/) ## Adverse effects ### Common - Nausea, headache, diarrhoea - Infusion reactions with fast infusion: upper-body flushing, urticaria, itching, back pain ### Serious (rare, important) - Anaphylaxis and serious skin reactions; the long half-life means effects of a reaction may last - Rise in ALT (liver enzyme) - Clostridioides difficile diarrhoea ## Contraindications - Known hypersensitivity to dalbavancin - Caution in patients with hypersensitivity to other glycopeptides ## Key interactions **Other glycopeptides (vancomycin)** Possible cross-hypersensitivity; the allergy history is reviewed. ## What is monitored - Signs of allergy during and after the infusion - Liver tests if symptoms appear - Clinical response of the skin infection ## Administration and safety - Reconstituted gently to avoid foaming and given as an IV infusion over the set time; fast infusion causes flushing and itching. - If an infusion reaction appears, the infusion is slowed or stopped. ## Nursing care - Ask about allergy to vancomycin or other glycopeptides before the dose. - Monitor the patient during the infusion for flushing, rash or breathing problems. - Teaching: the drug stays in the body for weeks; report rash, swelling or diarrhoea even after discharge. ## Pregnancy and breastfeeding Human data are limited; the pregnancy is reported to the treating team, and the drug is used only if the benefit justifies it. ## Memory aid DALBAVANCIN = «vancomycin with a DAy-Long-Baggage»: a lipid tail and an 8-day half-life, so one or two doses treat a skin infection. ## Test yourself Think of the answer, then tap the question to see it. ## Why can dalbavancin treat a skin infection with one or two doses? It is highly protein-bound and has an effective half-life of about 8.5 days. ## What structural feature separates dalbavancin from vancomycin? A lipid side chain that anchors it in the bacterial membrane and helps it dimerize, increasing potency. ## Which enterococci are often resistant to dalbavancin? Those carrying the vanA gene, which changes the D-Ala–D-Ala target. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/dalbavancin/) ## Related drugs - [Vancomycin](https://durgical.com/en/pharmacology/vancomycin/) - [Daptomycin](https://durgical.com/en/pharmacology/daptomycin/) - [Linezolid](https://durgical.com/en/pharmacology/linezolid/) ## Related conditions - [Cellulitis of the leg](https://durgical.com/en/conditions/cellulitis-of-the-leg/) - [Abscess, furuncle and carbuncle](https://durgical.com/en/conditions/abscess-furuncle-and-carbuncle/) [← Back to the class: Glycopeptides](https://durgical.com/en/pharmacology/classes/glycopeptides/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [DailyMed - DALBAVANCIN injection, powder, lyophilized, for solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4c0bd0f-03c2-4ce5-bcc2-b58f21ce75c1) (DailyMed (U.S. National Library of Medicine), 2026); [Dalbavancin Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a614036.html) (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 58 (McGraw Hill, 2023); [RCSB PDB - 1FVM: Complex of vancomycin with DI-acetyl-LYS-D-ALA-D-ALA](https://www.rcsb.org/structure/1FVM) (RCSB Protein Data Bank, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/dalbavancin/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/dalbavancin/