Dalbavancin as chronic antibiotic suppression therapy for left ventricular assist device driveline infection due to methicillin-resistant <i>Staphylococcus aureus</i>: a case report

Pallotto, Carlo; Tordi, Sara; Pantanella, Romina; Rosignoli, Daniele; Francisci, Daniela

doi:10.1080/1120009x.2022.2136426

Cited by 4 publications

(1 citation statement)

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“…The main purpose of this report is to share our experience with the prolonged use of this new agent, as no higher-quality evidence is available to date. To our knowledge, very limited experiences are reported with dalbavancin as a suppressive agent, mostly case reports ( Spaziante et al, 2019 ; Barbero Allende et al, 2021 ; Matesanz et al, 2021 ; Pallotto et al, 2022 ) or smaller series like the one retrospectively described by Hitzenbichler et al (2021) with four cases. Here, we report eight cases from different hospitals and with very prolonged therapies (as far as 21 months).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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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.

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