Real-World Data Regarding Dalbavancin Use before and during the COVID-19 Pandemic—A Single-Center Retrospective Study

Abstract

Dalbavancin is a semisynthetic lipoglycopeptide, which possesses great potential for bactericidal activity similar to antimicrobials with the same mechanism of action, such as vancomycin and teicoplanin. Due to its very prolonged half-life, it can be used in a single or two-dose regimen to treat infections by Gram-positive microorganisms, even resistant ones, such as methicillin-resistant Staphylococcus aureus (MRSA). Currently, it is approved only for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). The aim of this study was to investigate the clinical and microbiological characteristics of patients to whom dalbavancin was administered at the University Hospital of Heraklion and evaluate its use in regard to the COVID-19 pandemic. In total, 146 patients were included in this retrospective cohort study evaluating the use of dalbavancin from the first time it was used in 2017 until the end of 2022. The median age was 68 years (range: 21–96 years), and 86 (59%) patients were male. The most common indications for dalbavancin use were osteoarticular infections in 43%, followed by ABSSSIs in 37%, and cardiovascular infections in 10%. Dalbavancin was used empirically in one out of three patients, most commonly with the indication of ABSSSIs, and most commonly in the post-COVID-19 era. The most frequently isolated pathogens were coagulase-negative staphylococci in 70%, S. aureus in 27%, Enterococcus spp. in 22%, and Streptococcus spp. in 8%, while one out of three infections were polymicrobial. In 12% of patients, the infection was not cured, but no patients died. For patients with ABSSSIs, endocarditis and vascular infections, and bacteremia, the cure rates were more than 90%, and in osteoarticular infections, the cure rate was 76%. Thus, dalbavancin has great potential for use in complicated and invasive infections that may require prolonged intravenous antimicrobial treatment. However, further studies are required to formally investigate its role in such infections.

Reply to Martora et al. “reply to ‘Dalbavancin for the treatment of severe hidradenitis’

“…9 Dalbavancin administration has been associated with high cure rates in a variety of infections, even for off-label indications such as osteoarticular or cardiovascular infections, with reduced durations of hospitalization and hospital costs. 10 To conclude, we agree that several antimicrobials could be used in patients with HS either due to their antimicrobial or their anti-inflammatory action. However, Infectious disease consultation can be of practical value since particularities of patients' medical history may preclude using some antimicrobials that may cause more harm than benefit.…”

The Impact of Total Intravenous Anesthesia Versus Inhalational Anesthesia on Postoperative Cognitive Dysfunction in Elderly Patients

“…This review's primary aim is to critically assess and synthesize the existing evidence, highlighting the strengths and limitations of current research and identifying gaps in knowledge. By doing so, we aim to shed light on whether one anesthetic technique holds an advantage over the other when considering the cognitive well-being of elderly patients undergoing surgery (Ioannou et al, 2023). The elderly population is growing, and with it comes an increased focus on mitigating the risks associated with surgical procedures in this vulnerable group (Alamelu et al, 2023).…”