In this real-life study dalbavancin was primarily used in off-label indications for treatment of PJI, osteomyelitis and endocarditis. Success rate was high (89%), tolerability and safety were excellent in this setting” Wunsch et al (2019).
Dalbavancin, a lipoglycopeptide with prolonged half-life approved for the treatment of acute bacterial skin-and-soft-tissue-infections, can be used for the treatment of infections caused by gram-positive bacteria requiring long term treatment such as endocarditis, prosthetic joint infections (PJI) or osteomyelitis. Clinical data is limited in these settings.
OBJECTIVES: To evaluate indications, safety, tolerability and long-term outcomes of dalbavancin-treated patients.
PATIENTS AND METHODS: Our multicenter, retrospective study includes patients who received dalbavancin in Austria from September 2016 to March 2018. 90-day outcomes and tolerability were determined.
RESULTS: A total of 101 patients were included in 3 centers (57% male, median age 65 years). The treated infections were PJI (31%), osteomyelitis (29%), endocarditis (25%) and acute bacterial skin and soft tissue infections (12%). Concomitant use of other antimicrobial substances was common (63%). The mean total cumulative dose of dalbavancin was 3,357mg (±2,283mg). Clinical success rate was 89%. Side effects occurred in 3/101 patients.
CONCLUSION: In this real-life study dalbavancin was primarily used in off-label indications for treatment of PJI, osteomyelitis and endocarditis. Success rate was high (89%), tolerability and safety were excellent in this setting. Dalbavancin may therefore be used in these off-label indications as alternative treatment approach.
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Wunsch, S., Krause, R., Valentin, T., Prattes, J., Janata, O., Lenger, A., Bellmann-Weiler, R., Weiss, G. and Zollner-Schwetz, I. (2019) Multicenter clinical experience of real life Dalbavancin use in gram-positive infections. International Journal of Infectious Diseases. February 19th. .