Dalbavancin for treatment of implant-related methicillin-resistant Staphylococcus aureus osteomyelitis in an experimental rat model

Abstract

Dalbavancin is a new semisynthetic lipoglycopeptide with improved antimicrobial activity against various gram-positive pathogens. It demonstrates an extensive plasma half-life which permits outpatient parenteral antimicrobial therapy with weekly intervals and might therefore be an excellent treatment alternative for patients requiring prolonged antimicrobial therapy. The present study investigated dalbavancin monotherapy in an experimental implant-related methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis model. A clinical MRSA isolate and a Kirschner-wire were inserted into the proximal tibia of anaesthetized Sprague-Dawley rats. Four weeks after infection 34 animals were treated over 4 weeks with either dalbavancin (20 mg/kg loading-dose; 10 mg/kg daily), vancomycin (50 mg/kg twice daily) or left untreated. Twenty-four hours after the last treatment dose tibial bones and Kirschner-wires were harvested for microbiological examination. Based on quantitative bacterial cultures of osseous tissue, dalbavancin was as effective as vancomycin and both were superior to no treatment. No emergence of an induced glycopeptide-/lipoglycopeptide- resistance was observed after a treatment period of four weeks with either dalbavancin or vancomycin. In conclusion, monotherapy with dalbavancin was shown to be as effective as vancomycin for treatment of experimental implant-related MRSA osteomyelitis in rats, but both antimicrobials demonstrated only limited efficacy. Further studies are warranted to evaluate the clinical efficacy of dalbavancin for the treatment of periprosthetic S. aureus infections.

Prosthesis design of animal models of periprosthetic joint infection following total knee arthroplasty: A systematic review

“…In 2010, Bernthal et al [14] used the same method in that a stainless steel Kirschner wire was retrogradely injected into the distal femur of mice for PJI modeling ( Fig 2A ). The implant in the medullary cavity was originally designed to imitate PJI after TKA, but in fact, it might confuse osteomyelitis models with PJI models [40, 41]. Because of its simplicity and reproducibility of manipulation, many researchers still used this method for PJI modeling [17, 18, 20, 21, 42].…”

Staphylococcus Aureus Osteomyelitis as an Inducer of Tolerance to Escherichia Coli Pyelonephritis: an Experimental Study

“…Some experiments were repeated with rabbits subject to osteomyelitis as described above (ODP group, n = 7). After three weeks, the needle was removed and rabbits were given one single intravenous infusion of 20 mg/kg of dalbavancin (Angelini, Athens, Greece), as done in previous experiments 23 . One week after the dalbavancin infusion, rabbits of this group were subject to pyelonephritis, as described above.…”

Modern approach to antibacterial therapy in the practice of a surgeon

“…Также, тедизолид включен в Российские национальные рекомендации по лечению хирургических инфекций кожи и мягких тканей [7,9]. Помимо тедизолида применяются также даптомицин (липопептиды), цефтаролин (цефалоспорины), тигециклин (глицилциклины), телаванцин (гликопептиды) в качестве эпмирической терапии при наличии факторов риска MRSA-инфекции [8,21,45,[47][48][49][50][51].…”