Dalbavancin as suppressive antibiotic therapy in patients with prosthetic infections: efficacy and safety

Frontiers in Pharmacology

Pharmacology

María Núñez-Núñez¹  Francisco Javier Martínez-Marcos²  Nagore Lois-Martínez³  Andrés Ruiz-Sancho⁴  David Vinuesa-García⁴  Laura Castelo-Corral⁵  Mohd Hafiz Abdul-Aziz⁶ 

[1] Biosanitary Research Institute, Ibs Granada, Granada, Spain;Pharmacy Department, University Hospital Clinico San Cecilio, Granada, Spain;Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain;Infectious Diseases Department, Juan Ramón Jiménez Hospital, Huelva, Spain;Infectious Diseases Department, Severo Ochoa Hospital, Madrid, Spain;Infectious Diseases Department, University Hospital Clinico San Cecilio, Granada, Spain;Biosanitary Research Institute, Ibs Granada, Granada, Spain;Infectious Diseases Department, University Hospital Complexo A Coruña, A Coruña, Spain;University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia;

关键词: dalbavancin;    Gram-positive prosthetic infection;    suppressive antibiotic therapy;    antimicrobial stewardship;    antimicrobials;   

DOI  :  10.3389/fphar.2023.1185602

 received in 2023-03-13, accepted in 2023-06-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

Suppressive antibiotic therapy (SAT) is a strategy to alleviate symptoms and/or to reduce the progression of an infection when other treatment options cannot be used. Dalbavancin, due to its prolonged half-life, enables (bi) weekly dosing. Here, we report our multicenter real-life clinical experience with dalbavancin used as SAT in patients with prosthetic joint or vascular infections. Medical records of all adult patients with documented vascular or orthopedic chronic prosthetic infections, who received dalbavancin as SAT between 2016 and 2018 from four Spanish hospitals were reviewed for inclusion. Descriptive analysis of demographic characteristics, Charlson Comorbidity index, Barthel index, isolated pathogens and indication, concomitant antibiotic use, adverse events, and clinical outcome of SAT were performed. Eight patients were eligible for inclusion, where six patients had prosthetic vascular infections (aortic valve) and two patients had knee prosthetic joint infections. The most common pathogens were methicillin-susceptible Staphylococcus aureus and Enterococcus faecium. All patients had a history of prior antibiotic treatment for the prosthetic infection [median duration of antibiotic days 125 days (IQR, 28–203 days)]. The median number of dalbavancin doses was 29 (IQR, 9–61) and concomitant antibiotic use (n = 5, 62.5%). Clinical success was reported in 75% (n = 6) of patients. Adverse events were reported in two patients (mild renal and hepatic impairment). The median estimated cost savings due to the avoided hospital days was €60185 (IQR, 19,916–94984) per patient. Despite the limitations of our study, this preliminary data provides valuable insight to support further evaluation of dalbavancin for SAT in patients with prosthetic infections in the outpatient setting when alternative treatments are not feasible.

【 授权许可】

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Copyright © 2023 Ruiz-Sancho, Núñez-Núñez, Castelo-Corral, Martínez-Marcos, Lois-Martínez, Abdul-Aziz and Vinuesa-García.