Dalbavancin treatment for spondylodiscitis: multi-center clinical experience and literature review

Ramadan, Mohammad; Gallo, Raffaella; Lugarà, Marina; Gambardella, Michele; Oliva, Gabriella; Bertolino, Lorenzo; Andini, Roberto; Coppola, Nicola; Zampino, Rosa; Durante‐Mangoni, Emanuele

doi:10.1080/1120009x.2021.2015649

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Although case reports and small series describing the use of dalbavancin for vertebral osteomyelitis have been published [ 10 , 11 ], our sample is the largest published to date in the US healthcare system, where resources and payment structure differ significantly from other countries and result in additional challenges to the use of dalbavancin in the outpatient setting [ 12 ]. In addition to long-acting glycopeptides, oral antibiotics offer an alternative to daily intravenous antibiotics and peripherally inserted central catheters in the community.…”

Section: Discussionmentioning

confidence: 99%

Dalba Got Back? Use of Dalbavancin for the Treatment of Vertebral Osteomyelitis

Streifel,

Strnad,

Sikka

et al. 2024

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Dalba Got Back? Use of Dalbavancin for the Treatment of Vertebral Osteomyelitis

Streifel,

Strnad,

Sikka

et al. 2024

Open Forum Infectious Diseases

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“…In our patients, dalbavancin was prescribed as a monotherapy in seven patients, whereas in the remaining eight it was associated with other antibiotics. To date, many different regimens have been tested for the treatment of spondylodiscitis, and the overall number of patients that are treated with dalbavancin is low [ 26 , 27 ]. Further, larger, and well-designed studies are needed to guide the selection of the appropriate agents and the duration of the antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Real-life dalbavancin treatment for osteomyelitis and prosthetic joint infections has been shown to be effective and safe [ 24 , 25 ]. However, to date, not many clinical data are available for spondylodiscitis [ 26 , 27 ]. Additionally, a proof-of-concept study recently highlighted the clinical usefulness that therapeutic drug monitoring (TDM) may have in estimating the duration of dalbavancin optimal target attainments in osteoarticular staphylococcal infections [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Off-Label Use of Dalbavancin for Sequential Treatment of Spondylodiscitis by Methicillin-Resistant Staphylococcus aureus: A Retrospective Single-Centre Experience

et al. 2022

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Our aim was to describe the clinical outcome and safety of the sequential treatment with off-label dalbavancin in patients with spondylodiscitis that is caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods: We retrospectively included all patients >18 years of age with spondylodiscitis that is caused by MRSA that was treated with dalbavancin from January 2018-January 2021, recording the instances of clinical cure/failure, adverse events, and the need to be re-hospitalized after the initiation of dalbavancin. In 2/15 patients, we performed therapeutic drug monitoring (TDM) for dalbavancin. Results: We included 15 patients, 53.3% of them were females, with a median age of 67.9 years (57.4–78.5); 100% patients reported back pain, while a fever was present only in 2/15 cases. The spondylodiscitis was localized in 86.6% cases at the lumbar level. A median of a 2-week in-hospital intravenous vancomycin was followed by dalbavancin with a median duration of 12 weeks (12–16). All patients reported a clinical cure, except for a woman who is still on a suppressive treatment. No patient needed to be re-hospitalized, access to emergency department, or experienced adverse events. The TDM for dalbavancin showed that more than 90% of the determinations were above the pharmacodynamic target against staphylococci. Conclusions: The results from our unique, even if it was small, cohort demonstrated that dalbavancin can be a safe/effective option as a sequential treatment in patients with serious infections requiring prolonged antibiotic therapy, such as spondylodiscitis.

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“…The most frequently used regimen was two weekly doses of 1500 mg, but also one dose of 1000 mg, followed by weekly doses of 500 mg for 6 weeks. Five months after discharge, no deaths were observed, but 42% of the patients required additional antibiotics for signs of infection on follow-up imaging [63]. Other retrospective studies with a small number of patients with spondylodiscitis treated with dalbavancin showed that it is well tolerated with low rates of adverse events, while cure rates varied from 33% to 100% [28,38,42,45,49,56,64,65].…”

Section: Dalbavancin Treatment In Spondylodiscitismentioning

confidence: 92%

“…One multicenter retrospective study evaluating the efficacy and safety of dalbavancin in 13 patients with spondylodiscitis demonstrated that the drug was well tolerated with minimal adverse effects. Clinical success was achieved in 85% of the patients during hospitalization, while additional antibiotics were required in the remaining two cases [63]. The most frequently used regimen was two weekly doses of 1500 mg, but also one dose of 1000 mg, followed by weekly doses of 500 mg for 6 weeks.…”

Section: Dalbavancin Treatment In Spondylodiscitismentioning

confidence: 99%

A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections

Dimopoulou,

Mantadakis,

Koutserimpas

et al. 2023

Antibiotics

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Bone and joint infections (BJI) require prolonged antimicrobial treatment, leading to lengthy hospitalizations, high costs, the risk of nosocomial infections, and the development of antimicrobial resistance. Dalbavancin is a novel semisynthetic lipoglycopeptide approved for the treatment of adults and children with acute bacterial skin and skin structure infections. This narrative review aims to summarize the characteristics of dalbavancin and the current scientific evidence regarding its clinical efficacy and safety in the treatment of BJI. A literature search until June 2023 was performed to identify all published research about the role of dalbavancin in the management of BJI. Due to its unique pharmacokinetics characterized by prolonged half-life, high bactericidal activity against most Gram-positive bacteria, a good safety profile, and high tissue penetration, dalbavancin can be a valuable alternative to the treatment of BJI. Clinical studies have shown its non-inferiority compared to conventional therapies in BJI, offering potent activity against key pathogens and an extended dosing interval that may shorten hospitalization. In conclusion, dalbavancin represents a promising treatment option for BJI with a favorable safety profile, but further research in both adults and particularly children, who are ideal candidates for long-acting antibiotics, is necessary to evaluate the role of dalbavancin in BJI.

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Dalbavancin treatment for spondylodiscitis: multi-center clinical experience and literature review

Cited by 7 publications

References 19 publications

Dalba Got Back? Use of Dalbavancin for the Treatment of Vertebral Osteomyelitis

Dalba Got Back? Use of Dalbavancin for the Treatment of Vertebral Osteomyelitis

Off-Label Use of Dalbavancin for Sequential Treatment of Spondylodiscitis by Methicillin-Resistant Staphylococcus aureus: A Retrospective Single-Centre Experience

A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections

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