Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection

Hajnal-Gabriela Illes; Anca Lupu; Bouchra Loutfi; Catherine Hoskovec; Jean-Marc Rogero; Laurent Delbast; Mohamed Acra; Damien Mondon

doi:doi:10.11648/j.cmr.20221103.16

Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection

Hajnal-Gabriela Illes, Anca Lupu, Bouchra Loutfi, Catherine Hoskovec, Jean-Marc Rogero, Laurent Delbast, Mohamed Acra, Damien Mondon

Published in Clinical Medicine Research (Volume 11, Issue 3)

Received: 18 May 2022 Accepted: 6 June 2022 Published: 14 June 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.

Published in	Clinical Medicine Research (Volume 11, Issue 3)
DOI	10.11648/j.cmr.20221103.16
Page(s)	74-80
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Dalbavancin, Bone and Joint Infection, Prosthetic Joint Infections, Osteomyelitis

References

[1]	Ajaka L, Heil E, Schmalzle S. Dalbavancin in the Treatment of Bacteremia and Endocarditis in People with Barriers to Standard Care. Antibiotics (Basel). 2020 Oct 15; 9 (10): 700. doi: 10.3390/antibiotics9100700. PMID: 33076275; PMCID: PMC7602462.
[2]	Almangour TA, Perry GK, Terriff CM, Alhifany AA, Kaye KS. Dalbavancin for the management of grampositive osteomyelitis: Effectiveness and potential utility. Diagn Microbiol Infect Dis. 2019 Mar; 93 (3): 213-218. doi: 10.1016/j.diagmicrobio.2018.10.007. Epub 2018 Oct 16. PMID: 30396697.
[3]	Almangour TA, Perry GK, Alhifany AA. Dalbavancin versus standard of care for the treatment of osteomyelitis in adults: A retrospective matched cohort study. Saudi Pharm J. 2020 Apr; 28 (4): 460-464. doi: 10.1016/j.jsps.2020.02.007. Epub 2020 Feb 17. PMID: 32273805; PMCID: PMC7132597.
[4]	Bartoletti M, Mikus E, Pascale R, Giannella M, Tedeschi S, Calvi S, Tenti E, Tumietto F, Viale P. Clinical experience with dalbavancin for the treatment of deep sternal wound infection. J Glob Antimicrob Resist. 2019Sep; 18: 195-198. doi: 10.1016/j.jgar.2019.03.015. Epub 2019 Mar 27. PMID: 30926464.
[5]	Bork JT, Heil EL, Berry S, Lopes E, Davé R, Gilliam BL, Amoroso A. Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections. Infect Dis Ther. 2019 Jun; 8 (2): 171-184. doi: 10.1007/s40121-019-0247-0. Epub 2019 May 3. PMID: 31054088; PMCID: PMC6522607.
[6]	Bouza E, Valerio M, Soriano A, Morata L, Carus EG, Rodríguez-González C, Hidalgo-Tenorio MC, Plata A, Muñoz P, Vena A; DALBUSE Study Group (Dalbavancina: Estudio de su uso clinico en España). Dalbavancin in the treatment of different gram-positive infections: a real-life experience. Int J Antimicrob Agents. 2018 Apr; 51 (4): 571-577. doi: 10.1016/j.ijantimicag.2017.11.008. Epub 2017 Nov 24. PMID: 29180276.
[7]	Buzón Martín L, Mora Fernández M, Perales Ruiz JM, Ortega Lafont M, Álvarez Paredes L, Morán Rodríguez MA, Fernández Regueras M, Machín Morón MA, Mejías Lobón G. Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: A proposal for a low dose strategy. A retrospective cohort study. Rev Esp Quimioter. 2019 Dec; 32 (6): 532-538. Epub 2019 Oct 22. PMID: 31642637; PMCID: PMC6913079.
[8]	Candiani G, Abbondi M, Borgonovi M, Romanò G, Parenti F. In-vitro and in-vivo antibacterial activity of BI397, a new semi-synthetic glycopeptide antibiotic. J Antimicrob Chemother. 1999 Aug; 44 (2): 179-92. doi: 10.1093/jac/44.2.179. PMID: 10473224.
[9]	Dinh A, Duran C, Pavese P, Khatchatourian L, Monnin B, Bleibtreu A, Denis E, Etienne C, Rouanes N, Mahieu R, Bouchand F, Davido B, Lotte R, Cabaret P, Camou F, Chavanet P, Assi A, Limonta S, Lechiche C, Riou R, Courjon J, Illes G, Lacassin-Beller F, Senneville E; Dalbavancin French Study Group. French national cohort of first use of dalbavancin: A high proportion of off-label use. Int J Antimicrob Agents. 2019 Nov; 54 (5): 668-672 doi: 10.1016/j.ijantimicag.2019.08.006. Epub 2019 Aug 7. PMID: 31400471.
[10]	Dunne MW, Puttagunta S, Sprenger CR, Rubino C, Van Wart S, Baldassarre J. Extended-duration dosing and distribution of dalbavancin into bone and articular tissue. Antimicrob Agents Chemother. 2015 Apr; 59 (4): 1849-55. doi: 10.1128/AAC.04550-14. Epub 2015 Jan 5. PMID: 25561338; PMCID: PMC4356775.
[11]	Dunne MW, Talbot GH, Boucher HW, Wilcox M, Puttagunta S. Safety of Dalbavancin in the Treatment of Skin and Skin Structure Infections: A Pooled Analysis of Randomized, Comparative Studies. Drug Saf. 2016 Feb; 39 (2): 147-57. doi: 10.1007/s40264-015-0374-9. PMID: 26715497; PMCID: PMC4735234.
[12]	European Medicines Agency (EMA). Xydalba summary of productcharacteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR__Product_Information/human/002840/WC500183869.pdf [[accessed 1 sept 2020].
[13]	Hoen B, Béguinot I, Rabaud C, Jaussaud R, Selton-Suty C, May T, Canton P. The Duke criteria for diagnosing infective endocarditis are specific: analysis of 100 patients with acute fever or fever of unknown origin. Clin Infect Dis. 1996 Aug; 23 (2): 298-302. doi: 10.1093/clinids/23.2.298. PMID: 8842267.
[14]	Knafl D, Tobudic S, Cheng SC, Bellamy DR, Thalhammer F. Dalbavancin reduces biofilms of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE). Eur J Clin Microbiol Infect Dis. 2017 Apr; 36 (4): 677-680. doi: 10.1007/s10096-016-2845-z. Epub 2016 Nov 28. PMID: 27896496; PMCID: PMC5366172.
[15]	Leighton A, Gottlieb AB, Dorr MB, Jabes D, Mosconi G, VanSaders C, Mroszczak EJ, Campbell KC, Kelly E. Tolerability, pharmacokinetics, and serum bactericidal activity of intravenous dalbavancin in healthy volunteers. Antimicrob Agents Chemother. 2004 Mar; 48 (3): 940-5. doi: 10.1128/AAC.48.3.940-945.2004. PMID: 14982787; PMCID: PMC353075.
[16]	Lemaignen A, Bernard L, Marmor S, Ferry T, Grammatico-Guillon L, Astagneau P; Scientific Committee for Complex Bone and Joint Infections Reference Centers (CRIOAc), on behalf of the CRIOAc network. Epidemiology of complex bone and joint infections in France using a national registry: The CRIOAc network. JInfect. 2021 Feb; 82 (2): 199-206. doi: 10.1016/j.jinf.2020.12.010. Epub 2020 Dec 19. PMID: 33352213.
[17]	Matt M, Duran C, Courjon J, Lotte R, Moing VL, Monnin B, Pavese P, Chavanet P, Khatchatourian L, Tattevin P, Cattoir V, Lechiche C, Illes G, Lacassin-Beller F, Senneville E, Dinh A; Dalbavancin French Study Group. Dalbavancin treatment for prosthetic joint infections in real-life: a national cohort study and literature review. JGlob Antimicrob Resist. 2021 May 4; 25: 341-345. doi: 10.1016/j.jgar.2021.03.026. Epub ahead of print. PMID: 33962065.
[18]	Morata L, Cobo J, Fernández-Sampedro M, Guisado Vasco P, Ruano E, Lora-Tamayo J, Sánchez Somolinos M, González Ruano P, Rico Nieto A, Arnaiz A, Estébanez Muñoz M, Jiménez-Mejías ME, Lozano Serrano AB, Múñez E, Rodriguez-Pardo D, Argelich R, Arroyo A, Barbero JM, Cuadra F, Del Arco A, Del Toro MD, Guio L, Jimenez-Beatty D, Lois N, Martin O, Martínez Alvarez RM, Martinez-Marcos FJ, Porras L, Ramírez M, Vergas García J, Soriano A. Safety and Efficacy of Prolonged Use of Dalbavancin in Bone and Joint Infections. Antimicrob Agents Chemother. 2019 Apr 25; 63 (5): e02280-18. doi: 10.1128/AAC.02280-18. PMID: 30858217; PMCID: PMC6496098.
[19]	Rappo U, Puttagunta S, Shevchenko V, Shevchenko A, Jandourek A, Gonzalez PL, Suen A, Mas Casullo V, Melnick D, Miceli R, Kovacevic M, De Bock G, Dunne MW. Dalbavancin for the Treatment of Osteomyelitis in Adult Patients: A Randomized Clinical Trial of Efficacy and Safety. Open Forum Infect Dis. 2018 Dec 10; 6 (1): ofy331. doi: 10.1093/ofid/ofy331. PMID: 30648126; PMCID: PMC6326511.
[20]	Tobudic S, Forstner C, Burgmann H, Lagler H, Ramharter M, Steininger C, Vossen MG, Winkler S, Thalhammer F. Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna. Clin Infect Dis. 2018 Aug 16; 67 (5): 795-798. doi: 10.1093/cid/ciy279. PMID: 29659732.
[21]	Tobudic S, Forstner C, Burgmann H, Lagler H, Steininger C, Traby L, Vossen MG, Winkler S, Thalhammer F. Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection. Infection. 2019 Dec; 47 (6): 1013-1020. doi: 10.1007/s15010-019-01354-x. Epub 2019 Sep 13. Erratum in: Infection. 2019 Nov 18; PMID: 31520397.
[22]	Trujillano Ruiz A, Mesquida Riera J, Serrano Fabiá MA, Riera Pérez E, Mejía Benard A, Taberner Ferrer MD. Prolonged treatment with dalbavancin in prosthetic hip infection by methicillin-resistant Staphylococcus epidermidis. Rev Esp Quimioter. 2019 Apr; 32 (2): 203-204. Epub 2019 Mar 13.
[23]	Streit JM, Fritsche TR, Sader HS, Jones RN. Worldwide assessment of dalba-vancin activity and spectrum against over 6,000 clinical isolates. Diagn Micro-biol Infect Dis 2004; 48: 137–43. doi: 10.1016/j.diagmicrobio.2003.09.004.
[24]	US Food and Drug Administration (FDA) DALVANCETM highlights of prescrib-ing information. http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021883s000lbl.pdf [accessed 4 mai 2022].
[25]	Wunsch S, Krause R, Valentin T, Prattes J, Janata O, Lenger A, Bellmann-Weiler R, Weiss G, Zollner-Schwetz I. Multicenter clinical experience of real life Dalbavancin use in gram-positive infections. Int J Infect Dis. 2019 Apr; 81: 210-214. doi: 10.1016/j.ijid.2019.02.013. Epub 2019 Feb 19. PMID: 30794940.

Cite This Article

Plain Text BibTeX RIS

APA Style

Hajnal-Gabriela Illes, Anca Lupu, Bouchra Loutfi, Catherine Hoskovec, Jean-Marc Rogero, et al. (2022). Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clinical Medicine Research, 11(3), 74-80. https://doi.org/10.11648/j.cmr.20221103.16

Copy | Download

ACS Style

Hajnal-Gabriela Illes; Anca Lupu; Bouchra Loutfi; Catherine Hoskovec; Jean-Marc Rogero, et al. Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clin. Med. Res. 2022, 11(3), 74-80. doi: 10.11648/j.cmr.20221103.16

Copy | Download

AMA Style

Hajnal-Gabriela Illes, Anca Lupu, Bouchra Loutfi, Catherine Hoskovec, Jean-Marc Rogero, et al. Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clin Med Res. 2022;11(3):74-80. doi: 10.11648/j.cmr.20221103.16

Copy | Download

@article{10.11648/j.cmr.20221103.16,
  author = {Hajnal-Gabriela Illes and Anca Lupu and Bouchra Loutfi and Catherine Hoskovec and Jean-Marc Rogero and Laurent Delbast and Mohamed Acra and Damien Mondon},
  title = {Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {74-80},
  doi = {10.11648/j.cmr.20221103.16},
  url = {https://doi.org/10.11648/j.cmr.20221103.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.16},
  abstract = {Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection
AU  - Hajnal-Gabriela Illes
AU  - Anca Lupu
AU  - Bouchra Loutfi
AU  - Catherine Hoskovec
AU  - Jean-Marc Rogero
AU  - Laurent Delbast
AU  - Mohamed Acra
AU  - Damien Mondon
Y1  - 2022/06/14
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.16
DO  - 10.11648/j.cmr.20221103.16
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 74
EP  - 80
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.16
AB  - Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.
VL  - 11
IS  - 3
ER  -

Copy | Download

Author Information

Hajnal-Gabriela Illes

Private Hospital Francheville, Perigueux, France
Anca Lupu

Public Hospital Pays des Sources, Mont de Marsan, France
Bouchra Loutfi

Public Hospital Pays des Sources, Mont de Marsan, France
Catherine Hoskovec

Public Hospital Pays des Sources, Mont de Marsan, France
Jean-Marc Rogero

Public Hospital Pays des Sources, Mont de Marsan, France
Laurent Delbast

Public Hospital Pays des Sources, Mont de Marsan, France
Mohamed Acra

Public Hospital Pays des Sources, Mont de Marsan, France
Damien Mondon

Public Hospital Pays des Sources, Mont de Marsan, France

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Hajnal-Gabriela Illes, Anca Lupu, Bouchra Loutfi, Catherine Hoskovec, Jean-Marc Rogero, et al. (2022). Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clinical Medicine Research, 11(3), 74-80. https://doi.org/10.11648/j.cmr.20221103.16

Copy | Download

ACS Style

Hajnal-Gabriela Illes; Anca Lupu; Bouchra Loutfi; Catherine Hoskovec; Jean-Marc Rogero, et al. Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clin. Med. Res. 2022, 11(3), 74-80. doi: 10.11648/j.cmr.20221103.16

Copy | Download

AMA Style

Hajnal-Gabriela Illes, Anca Lupu, Bouchra Loutfi, Catherine Hoskovec, Jean-Marc Rogero, et al. Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection. Clin Med Res. 2022;11(3):74-80. doi: 10.11648/j.cmr.20221103.16

Copy | Download

@article{10.11648/j.cmr.20221103.16,
  author = {Hajnal-Gabriela Illes and Anca Lupu and Bouchra Loutfi and Catherine Hoskovec and Jean-Marc Rogero and Laurent Delbast and Mohamed Acra and Damien Mondon},
  title = {Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {74-80},
  doi = {10.11648/j.cmr.20221103.16},
  url = {https://doi.org/10.11648/j.cmr.20221103.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.16},
  abstract = {Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection
AU  - Hajnal-Gabriela Illes
AU  - Anca Lupu
AU  - Bouchra Loutfi
AU  - Catherine Hoskovec
AU  - Jean-Marc Rogero
AU  - Laurent Delbast
AU  - Mohamed Acra
AU  - Damien Mondon
Y1  - 2022/06/14
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.16
DO  - 10.11648/j.cmr.20221103.16
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 74
EP  - 80
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.16
AB  - Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.
VL  - 11
IS  - 3
ER  -

Copy | Download