Multidose Dalbavancin Population Pharmacokinetic Analysis for Prolonged Target Attainment in Patients Requiring Long-Term Treatment

Dalbavancin is a long-acting antibiotic effective against multidrug-resistant Gram-positive infections, but the optimal multidose regimen for achieving pharmacokinetic/pharmacodynamic targets in patients requiring prolonged treatment had not been established. This study built a population pharmacokinetic model using a nonlinear mixed-effects approach in NONMEM, then used Monte Carlo simulation to evaluate multidose dalbavancin regimens across different body weight bands for patients with adequate renal function. Two 1500 mg doses given seven days apart achieved over 90% target attainment for three to five weeks depending on body weight, and adding a third dose extended this optimal window to six to nine weeks. The findings support a practical, weight-based multidose dalbavancin strategy, with additional doses guided by therapeutic drug monitoring or empirical timing based on body weight for patients requiring long-term treatment.