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- Title
Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection.
- Authors
Tobudic, Selma; Forstner, Christina; Burgmann, Heinz; Lagler, Heimo; Steininger, Christoph; Traby, Ludwig; Vossen, Mathias G.; Winkler, Stefan; Thalhammer, Florian
- Abstract
Purpose: Dalbavancin is a novel lipoglycopeptide with potent activity against several gram-positive pathogens, an excellent safety profile and a long elimination half-life. Methods: In this case series observed at the University Hospital of Vienna between 2015 and 2017, all adult patients with gram-positive infections who received at least one dosage of dalbavancin were screened (n = 118). A total of 72 patients were included in the final analysis. The number of included patients stratified by the source of infection was: skin and soft tissue infection (SSTI) (n = 26), osteomyelitis (n = 20), spondylodiscitis (n = 14), acute septic arthritis (n = 4) and prosthetic joint infection (n = 8). Results: In 46 patients (64%), clinical cure was detected at the end of dalbavancin therapy without additional antibiotic therapy. Of the 26 patients who received additional antibiotic therapy other than dalbavancin, 15 patients (21%) showed no clinical improvement under dalbavancin therapy, four patients (5%) had side effects (nausea n = 1, exanthema n = 2, hyperglycemia n = 1), and in seven patients (10%) clinical improvement under dalbavancin therapy was detected but antibiotic therapy was de-escalated to an oral drug. Conclusion: We demonstrated high clinical effectiveness of dalbavancin for acute gram-positive infections primarily acute SSTI, acute septic arthritis, acute osteomyelitis and spondylodiscitis. In patients with biofilm-associated infection (chronic infection or joint prosthesis), source control was absolutely necessary for treatment success.
- Subjects
AUSTRIA; ANTIBIOTICS; ACADEMIC medical centers; BIOFILMS; COMMUNICABLE diseases; EXANTHEMA; HYPERGLYCEMIA; INFECTION; INFECTIOUS arthritis; NAUSEA; ORAL drug administration; OSTEOMYELITIS; COMPLICATIONS of prosthesis; SKIN diseases; GRAM-positive bacterial infections; TREATMENT effectiveness; SOFT tissue infections; DISCITIS
- Publication
Infection, 2019, Vol 47, Issue 6, p1013
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-019-01354-x