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Esposito S, Pagliano P, De Simone G, Guarino A, Pan A, Brambilla P, Mastroianni C, Lichtner M, Brugnaro P, Carretta A, Santantonio T, Brindicci G, Carrega G, Montagnani F, Lapadula G, Spolti A, Luzzati R, Schiaroli E, Scaglione V, Pallotto C, Tacconi D, Quintieri F, Trecarichi E. In-label, off-label prescription, efficacy and tolerability of dalbavancin: report from a National Registry. Infection 2024:10.1007/s15010-024-02176-2. [PMID: 38324144 DOI: 10.1007/s15010-024-02176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Although dalbavancin is currently approved for the treatment of ABSSIs, several studies suggest its efficacy and tolerance as long-term therapy for other off-label indications requiring prolonged intravenous antibiotic administration. METHODS We conducted a prospective nationwide study of dalbavancin use in real-life settings for both approved and off-label indications analysing for each case the clinical and microbiological characteristics of infection the efficacy and safety of treatments. RESULTS During the study period (from December 2018 to July 2021), the ID specialists from 14 different centres enrolled 223 patients treated with dalbavancin [141 males (63%) and 82 females (37%); male/female ratio 1.72; mean age 59 (SD 17.2) years, (range 15-96). Most patients in the study population (136/223; 61.0%) came from community rather than health care facilities and most of them were visited in Infectious Diseases wards (93/223; 41.7%) and clinics (55/223; 24.7%) even though some patients were cured in other settings, such as surgery wards (18/223; 8.1%), orthopaedic wards (11/223; 4.9%), Emergency Rooms (7/223; 3.1%) and non-surgical other than ID wards (6/223; 2.7%). The most common ID diagnoses were osteomyelitis (44 cases/223; 19.7%; of which 29 acute and 15 chronic osteomyelitis), cellulitis (28/223; 12.5%), cutaneous abscess (23/223; 10.3%), orthopaedic prosthesis-associated infection (22/223; 9.9%), surgical site infection (20/223; 9.0%) and septic arthritis (15/223; 6.7%). CONCLUSION In conclusion, by virtue of its PK/PD properties, dalbavancin represents a valuable option to daily in-hospital intravenous or outpatient antimicrobial regimens also for off-label indications requiring a long-term treatment of Gram-positive infections.
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Affiliation(s)
- Silvano Esposito
- Department of Infectious Diseases, University of Salerno, Salerno, Italy.
| | - Pasquale Pagliano
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Giuseppe De Simone
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Amedeo Guarino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Angelo Pan
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Paola Brambilla
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University, Latina, Italy
| | - Pierluigi Brugnaro
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Anna Carretta
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Teresa Santantonio
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | | | - Giuliana Carrega
- Infectious Diseases Unit, Santa Maria Della Misericordia Hospital, Albenga, Savona, Italy
| | | | | | - Anna Spolti
- Infectious Diseases Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Vittoria Scaglione
- Department of Infectious Diseases, University of Perugia, Perugia, Italy
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