Use of Dalbavancin in Skin, Bone and Joint Infections: A Real-Life Experience in an Italian Center

Brescini, Lucia; Martera, Filippo Della; Morroni, Gianluca; Mazzanti, Sara; Pietrantonio, Maria Di; Mantini, Paolo; Candelaresi, Bianca; Pallotta, Francesco; Olivieri, Silvia; Iencinella, Valentina; Castelletti, Sefora; Cocci, Emanuele; Polo, Rosaria G.; Veccia, Salvatore; Cirioni, Oscar; Tavio, Marcello; Giacometti, Andrea

doi:10.3390/antibiotics10091129

Cited by 13 publications

(2 citation statements)

References 22 publications

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“…These results are similar to those reported by Phase 3 clinical trials, which displayed clinical success in patients infected by S. aureus of 90.6% with dalbavancin and 93.8% with vancomycin/linezolid, 4 and by real-life settings. 19 , 23 , 24 , 41 …”

Section: Discussionmentioning

confidence: 99%

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Bai

Mazzitelli

Silvola

et al. 2023

JAC-Antimicrobial Resistance

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Objectives Thanks to its long half-life, dalbavancin qualifies as an optimal drug for saving costs. We aimed to assess the cost and effectiveness of dalbavancin versus the standard of care (SoC). Patients and methods We conducted a multicentre retrospective study, including all hospitalized or outpatients diagnosed with ABSSSIs at Padua University Hospital, Padua and San Paolo Hospital, Milan (1 January 2016 to 31 July 2020). We compared patients according to antibiotic treatment (dalbavancin versus SoC), the number of lines of dalbavancin treatment, and monotherapy or combination (dalbavancin in association with other antibiotics). Primary endpoints were direct medical costs and length of hospital stay (LOS) associated with ABSSSI management; Student’s t-test, chi-squared test and one-way ANOVA were used. Results One hundred and twenty-six of 228 (55.3%) patients received SoC, while 102/228 (44.7%) received dalbavancin. Twenty-seven of the 102 (26.5%) patients received dalbavancin as first-line treatment, 46 (45.1%) as second-line, and 29 (28.4%) as third- or higher-line treatment. Most patients received dalbavancin as monotherapy (62/102; 60.8%). Compared with SoC, dalbavancin was associated with a significant reduction of LOS (5 ± 7.47 days for dalbavancin, 9.2 ± 5.59 days for SoC; P < 0.00001) and with lower mean direct medical costs (3470 ± 2768€ for dalbavancin; 3493 ± 1901€ for SoC; P = 0.9401). LOS was also reduced for first-line dalbavancin, in comparison with second-, third- or higher-line groups, and for dalbavancin monotherapy versus combination therapy. Mean direct medical costs were significantly lower in first-line dalbavancin compared with higher lines, but no cost difference was observed between monotherapy and combination therapy. Conclusions Monotherapy with first-line dalbavancin was confirmed as a promising strategy for ABSSSIs in real-life settings, thanks to its property in reducing LOS and saving direct medical costs.

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Section: Discussionmentioning

confidence: 99%

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Bai

Mazzitelli

Silvola

et al. 2023

JAC-Antimicrobial Resistance

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“…In addition, pharmacokinetic studies demonstrated that this new drug could reach an optimal concentration both in the bone and articular tissues [ 23 ]. 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 ].…”

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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Dalbavancin

2023

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Use of Dalbavancin in Skin, Bone and Joint Infections: A Real-Life Experience in an Italian Center

Cited by 13 publications

References 22 publications

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

Cost analysis of dalbavancin versus standard of care for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in two Italian hospitals

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

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