Efficacy of dalbavancin in the treatment of MRSA rat sternal osteomyelitis with mediastinitis

Barnea, Yoav; Lerner, Anat; Aizic, Asaf; Navon-Venezia, Shiri; Rachi, Eleanor; Dunne, Michael; Puttagunta, Sailaja; Carmeli, Yehuda

doi:10.1093/jac/dkv357

Cited by 33 publications

(29 citation statements)

References 18 publications

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“…Lack of source control was the primary reason for failure, as documented by persistently positive margins, wound dehiscence and persistent elevation of inflammatory markers. Dalbavancin has been shown to have high concentrations through day 14 in bone in rat studies, which is promising for clinical application [ 11 ]. Rappo et al performed a randomized clinical trial of dalbavancin in first-episode osteomyelitis treatment and found that patients treated with dalbavancin (1500 mg, 2 doses 1 week apart) had clinical cure at day 42 in 65/67 (97%) versus 7/8 (88%) in standard-of-care patients [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are limited data on the use of dalbavancin for indications other than 1–2 doses for treatment of ABSSSI. Case reports have demonstrated success in treating more complicated infections such as MRSA pneumonia, osteomyelitis and endovascular infections [ 9 – 11 ]. Dalbavancin for treatment of catheter-related bloodstream infections demonstrated efficacy in a small phase 2 open-label study with overall success of 87% (95% CI 73.2–100%) [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections

et al. 2019

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Introduction Dalbavancin is approved for acute bacterial skin and skin structure infections (ABSSSIs) but offers a potential treatment option for complicated invasive gram-positive infections. Importantly, dalbavancin’s real benefits may be in treating complicated infections in vulnerable patient populations, such as persons who inject drugs (PWID). Methods A multicenter retrospective analysis was performed from March 2014 to April 2017 to assess 30- and 90-day clinical cure and adverse drug events (ADEs) in adult patients who received ≥ 1 dose of dalbavancin for a non-ABSSSI indication. Results During the study period, 45 patients received dalbavancin, 28 for a non-ABSSSI indication. The predominant infections treated included osteomyelitis (46%), endovascular infection (25%) and uncomplicated bacteremia (14%). Half of the patients had positive Staphylococcus aureus in cultures, 29% methicillin resistant and 21% methicillin susceptible. Most patients were prescribed dalbavancin as sequential treatment with a median of 13.5 days of prior antibiotic therapy. The most common reason for choosing dalbavancin over standard therapy use was PWID (54%). Seven patients were lost to follow-up at day 30. Of the remaining evaluable patients, 30-day clinical cure was achieved in 15/21 (71%) patients. The most common reason for failure was lack of source control (4/6, 67%). At day 90, relapse occurred in two patients. Three patients had a potential dalbavancin-associated ADE: two patients with renal dysfunction and one patient with pruritus. Conclusions This study demonstrates a possible role for dalbavancin in the treatment of non-ABSSSI invasive gram-positive infections in select vulnerable OPAT patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections

et al. 2019

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“…Moreover, in an animal model study in which dalbavancin was compared with vancomycin for prevention of S. aureus colonization of devices, the former was more effective (Darouiche and Mansouri, 2005). Also in a recent study, dalbavancin was active in the treatment of MRSA rat sternal osteomyelitis (Barnea et al, 2016). However, in another study in which dalbavancin was tested against MRSA in a foreign-body infection model, it reduced planktonic MRSA in cage fluid at high doses, but failed to eradicate biofilms from the tissue cages (Baldoni et al, 2013).…”

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confidence: 99%

In vitro activity of dalbavancin against biofilms of staphylococci isolated from prosthetic joint infections

Fernández

Greenwood‐Quaintance

Patel

2016

Diagnostic Microbiology and Infectious Disease

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“…43 Furthermore, concerning bone drug penetration, dalbavancin effectiveness in the treatment of MRSA osteomyelitis was demonstrated in rats, showing a reduction in bone CFUs superior to placebo and similar to vancomycin. 44 No tissue accumulation after a multiple-dose regimen (1000 mg IV loading-dose on day 1 followed by 500 mg/ week for 7 weeks) was observed. 43 Dalbavancin elimination follows two routes (renal/ non-renal): after a 1000 mg single dose, in healthy volunteers, unchanged drug excretion into urine was 42% after 42 days, thus underlining the importance of non-renal elimination pathway.…”

Section: Discussionmentioning

confidence: 95%

The role of dalbavancin in the multi-disciplinary management of wound infections in orthopaedic surgery

Arena

Romanini

Rosi

et al. 2017

Journal of Chemotherapy

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Antimicrobial resistance is continuously increasing among bacterial clinical isolates (especially methicillin resistance in Staphylococcus aureus, MRSA), negatively impacting on outcomes of patients with Surgical Site Infections (SSIs). A multi-disciplinary team work is essential for SSIs prevention and for the choice of antibiotic therapy of orthopaedic SSIs. In particular, an Antibiotic Stewardship (AS) approach is recommended for preserving the activity of old and new antimicrobials. Dalbavancin is a novel antimicrobial agent, belonging to the lipoglycopeptides family, recently approved by FDA for the treatment of ABSSSIs (Acute Bacterial Skin and Skin Structure Infections) and can be considered as a candidate for the treatment of orthopaedic superficial SSIs. An antimicrobial activity directed against MRSA and other multi-resistant Gram-positive pathogens, a bactericidal effect and an extremely extended half-life are among key features of this drug. Dalbavancin gives to clinicians the option to provide an intravenous antimicrobial agent shown to be as effective as conventional therapies, without requiring prolonged admission into the hospital, drastically reducing the length of hospital stay (without reducing the treatment compliance) and total cost per patient. In this paper, we analyze general, microbiological and pharmacological features of dalbavancin, aiming at supporting clinicians while positioning this drug in the context of orthopaedic SSIs.

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Efficacy of dalbavancin in the treatment of MRSA rat sternal osteomyelitis with mediastinitis

Abstract: Dalbavancin is effective in the treatment of MRSA rat sternal osteomyelitis.

Cited by 33 publications

References 18 publications

Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections

Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections

In vitro activity of dalbavancin against biofilms of staphylococci isolated from prosthetic joint infections

The role of dalbavancin in the multi-disciplinary management of wound infections in orthopaedic surgery

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