Efficacy and safety of dalbavancin as suppressive therapy in chronic implant-associated infections - 02/06/26
on behalf of the Lyon BJI study group
Highlights |
• | Dalbavancin pharmacokinetics makes it attractive for suppressive antimicrobial therapy (SAT) of Gram-positive infections. |
• | Dalbavancin SAT was associated with an acceptable success rate in device-associated Gram-positive infection. |
• | Therapeutic drug monitoring allowed to lower the dose and increase dosing intervals in most patients. |
• | Failures with emergence of resistance were observed, advocating for close monitoring of treatment response. |
• | No adverse event was observed toward prolonged used of dalbavancin as SAT for Gram-positive chronic infections. |
Abstract |
Introduction |
Long-acting lipoglycopeptides represent an innovative suppressive antimicrobial therapy (SAT) for Gram-positive chronic infections. We aimed to describe the off-label use of dalbavancin SAT.
Methods |
Retrospective cohort including all patients receiving dalbavancin SAT.
Results |
Thirty-three patients received dalbavancin SAT for bone/joint (n = 27, 81.8%) or cardiovascular (n = 6, 18.2%) implant-related infections, mostly caused by coagulase-negative staphylococci (n = 27/44, 61.4%). After initial surgery (n = 29, 87.9%) and 83 (IQR, 70–125) days of curative therapy, SAT was prescribed because of the impact of a potential relapse (n = 13, 39.4%), incomplete surgical source control (n = 9, 27.3%), or previous failures (n = 7, 21.3%). The initial dalbavancin dose was most commonly 1,500 mg (n = 28, 84.8%), with a second dose of 1,500 mg (n = 19, 57.6%) 14 (IQR, 7–15) days apart. The third administration was carried out 28 (IQR, 27–31) days later (1,000 [n = 13, 39.4%] or 1,500 [n = 12, 36.4%] mg). A median of 7 (IQR, 5–11; min–max, 3–49) infusions were performed over a period of 210 (IQR, 107–532) days, with a last dose of 1,500 (n = 13, 39.4%), 1,000 (n = 13, 39.4%) or 500 (n = 7, 21.2%) mg at a 42 (IQR, 28–56) days interval. At the last follow-up, 21 patients were still on dalbavancin SAT with favorable outcome. Dalbavancin was discontinued in three patients with no sign of infection. Six relapses were observed with the same pathogen including four with increased dalbavancin MIC. No dalbavancin-related adverse events were observed.
Conclusion |
Dalbavancin SAT for implant-related infections was overall safe and effective, despite failures with emergence of resistance, advocating for close monitoring of treatment response.
Le texte complet de cet article est disponible en PDF.Keywords : Bone and joint infection, Dalbavancin, Prosthetic joint infection, Suppressive antimicrobial therapy
Plan
Vol 56 - N° 4
Article 105268- mai 2026 Retour au numéro
Article précédent
- Clinical practice recommendations for the management of hand Infections: A formalized CRIOGO consensus Guideline
- Raphaël Lecomte, Hélène Cormier, Marion Lacasse, Louis-Romée Le Nail, Chloé Labarre, Harold Common, Christophe Nich, Solène Patrat-Delon, Marion Baldeyrou, Adrien Lemaignen, Gwenaël Le Moal, Luc Quaesaet, Stéphane Corvec, Marie-Frédérique Lartigue, Sophie Reissier, Rachel Chenouard, Laura Chaufour, Diama Ndiaye, the CRIOGO study group
- Distribution of anti-diphtheria toxin antibodies in the Italian population by age, sex, and geographic region
- Francesco Bagordo, Alessandra Panico, Tiziana Grassi, Antonella Arghittu, Tatjana Baldovin, Giorgia Della Polla, Elvira Massaro, Emanuele Montomoli, Monica Giacomuzzi, Francesco Vitale, Marta Savio, Giovanni Gabutti, the Sero-epidemiological Study Group
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?