In-label, off-label prescription, efficacy and tolerability of dalbavancin: report from a National Registry.

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.

• Authors: Silvano Esposito, Pasquale Pagliano, Giuseppe De Simone, Amedeo Guarino, Angelo Pan, Paola Brambilla, Claudio Mastroianni, Miriam Lichtner, Pierluigi Brugnaro, Anna Carretta, Teresa Santantonio, Gaetano Brindicci, Giuliana Carrega, Francesca Montagnani, Giuseppe Lapadula, Anna Spolti, Roberto Luzzati, Elisabetta Schiaroli, Vittoria Scaglione, Carlo Pallotto, Danilo Tacconi, Francesco Quintieri, Enrico Trecarichi, Italian Society of Infectious, Tropical Diseases
• Journal: Infection (Infection) (Feb 07 2024) ISSN: 1439-0973 [Electronic] Germany
• PMID: 38324144 (Publication Type: Journal Article)
• Copyright: © 2024. The Author(s).