A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections

Dimopoulou, Dimitra; Mantadakis, Elpis; Koutserimpas, Christos; Samonis, George

doi:10.3390/antibiotics12101492

Cited by 4 publications

(1 citation statement)

References 78 publications

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“…Dalbavancin is a second-generation, intravenous lipoglycopeptide. Due to its favorable PKs characterized by a terminal half-life of 2 weeks-related in part to 93% protein binding-high bactericidal activity against most gram-positive bacteria, good safety profile and high tissue penetration, dalbavancin can be a valuable alternative in the treatment of ABSSSI as well as bone and joint infections [10][11][12][13][14]. Recommended use of dalbavancin is intravenous infusion over 30 min, at a dose of 1500 mg for adults, given either as a single infusion or as 1000 mg in the first week followed by 500 mg in the following week.…”

Section: Introductionmentioning

confidence: 99%

Real-World Use of Dalbavancin for Treatment of Soft Tissue and Bone Infection in Children: Safe, Effective and Hospital-Time Sparing

Caselli,

Mariani,

Colomba

et al. 2024

Children

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Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered as inpatient treatment at the price of an extended hospital stay. Between October 2019 and September 2023, 31 children and adolescents were treated with dalbavancin because of bone and joint infections (n = 12 patients, 39%), ABSSSI (n = 13 patients, 42%), mainly for the limbs, facial cellulitis or complicated ABSSSI (n = 6 patients, 19%), at five Italian pediatric centers. Microbiological study provided gram-positive bacterial isolate in 16 cases, in 11 cases from a positive blood culture; 9 of them were MRSA. Twenty-five patients were initially treated with a different antibiotic therapy: beta-lactam-based in 18 patients (58%), glycopeptide-based in 15 patients (48%) and daptomycin in 6 (19%). The median time that elapsed between admission and start of dalbavancin was 18 days. A total of 61 doses of dalbavancin were administered to the 31 patients: 16 received a single dose while the remaining 15 patients received between two (n = 9) and nine doses. The frequency of administration was weekly in five cases or fortnightly in nine patients. Median length of stay in hospital was 16 days. Median time to discharge after the first dose of dalbavancin was 1 day. Treatment was very well-tolerated: of the 61 administered doses, only four doses, administered to four patients, were associated with an adverse event: drug extravasation during intravenous administration occurred in two patients, with no sequelae; however, in two patients the first administration was stopped soon after infusion start: in one (ID #11), due to headache and vomiting; in another (ID #12) due to a systemic reaction. In both patients, drug infusion was not repeated. None of the remaining 29 patients reported treatment failure (resistant or recurrent disease) or an adverse effect during a median follow-up time of two months. The use of dalbavancin was safe, feasible and also effective in shortening the hospital stay in children and adolescents.

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