Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application
<p>Dalbavancin is a lipoglycopeptide with a half-life of 14 d, significantly reducing the need for daily antibiotic dosing. Although dalbavancin is approved for acute bacterial skin and skin structure infections, its off-label use in complex musculoskeletal infection (MSKI) is increasing. Evid...
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Copernicus Publications
2025-03-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/10/93/2025/jbji-10-93-2025.pdf |
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| author | T. Azamgarhi S. Warren A. Scobie N. Karunaharan C. Perez-Sanchez R. Houghton S. Hassan J. Lourtet-Hascoët J. Lourtet-Hascoët H. Kershaw P. Sendi K. Saeed K. Saeed |
| author_facet | T. Azamgarhi S. Warren A. Scobie N. Karunaharan C. Perez-Sanchez R. Houghton S. Hassan J. Lourtet-Hascoët J. Lourtet-Hascoët H. Kershaw P. Sendi K. Saeed K. Saeed |
| author_sort | T. Azamgarhi |
| collection | DOAJ |
| description | <p>Dalbavancin is a lipoglycopeptide with a half-life of 14 d, significantly reducing the need for daily antibiotic dosing. Although dalbavancin is approved for acute bacterial skin and skin structure infections, its off-label use in complex musculoskeletal infection (MSKI) is increasing. Evidence on its effectiveness for MSKI, especially in facilitating early discharge for patients unsuitable for oral or OPAT (outpatient parenteral antimicrobial therapy) treatments, is limited.</p>
<p><span id="page94"/>This multi-centre observational study aims to evaluate dalbavancin's role in facilitating discharge and improving clinical outcomes in MSKI. <strong>Method</strong>: this study included adult patients treated with dalbavancin between January 2017 and December 2022 across five hospitals in the UK and France. Data on patient demographics, clinical characteristics, microbiology and treatment outcomes were collected using a standardised form. The study also compared treatment costs between dalbavancin and hypothetical alternatives involving either inpatient care or OPAT. Clinical success was defined as the absence of definite failure based on the OVIVA (oral versus intravenous antibiotics) trial criteria. <strong>Results</strong>: a total of 39 patients were included, with a median age of 51 years (interquartile range (IQR) 40–72). Prosthetic joint infections (38 %) and septic arthritis (31 %) were the most common indications for dalbavancin use. The primary pathogens identified were <i>Staphylococcus aureus</i> (51 %) and coagulase-negative staphylococci (44 %). Dalbavancin was primarily chosen due to poor adherence or lack of OPAT options in 77 % of cases and for convenience in 23 %. In the necessity group, the use of dalbavancin resulted in a median cost saving of GBP 8894 per patient, and 31 inpatient days were avoided. Of the 32 patients (82 %) assigned a definite outcome, 72 % achieved clinical success. No significant adverse drug reactions were reported. <strong>Conclusion</strong>: this study fills an important evidence gap by demonstrating that dalbavancin is a viable and cost-effective option for MSKI patients that are unsuitable for oral or OPAT treatments. Dalbavancin facilitates early discharge, reduces hospital stays and achieves comparable clinical outcomes to conventional therapies.</p> |
| format | Article |
| id | doaj-art-64fdba13bf2d4e0b81494cf98d65b92a |
| institution | DOAJ |
| issn | 2206-3552 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Copernicus Publications |
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| series | Journal of Bone and Joint Infection |
| spelling | doaj-art-64fdba13bf2d4e0b81494cf98d65b92a2025-08-20T02:50:00ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522025-03-01109310010.5194/jbji-10-93-2025Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life applicationT. Azamgarhi0S. Warren1A. Scobie2N. Karunaharan3C. Perez-Sanchez4R. Houghton5S. Hassan6J. Lourtet-Hascoët7J. Lourtet-Hascoët8H. Kershaw9P. Sendi10K. Saeed11K. Saeed12Pharmacy Department, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, HA7 4LP, United KingdomBone Infection Unit, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, HA7 4LP, United KingdomBone Infection Unit, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, HA7 4LP, United KingdomBone Infection Unit, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, HA7 4LP, United KingdomPharmacy Department, University Hospital Southampton NHS Foundation Trust, Southampton, United KingdomDepartment of Microbiology, Hampshire Hospitals NHS Foundation Trust, Hampshire, Basingstoke, United KingdomDepartment of Microbiology, Hampshire Hospitals NHS Foundation Trust, Hampshire, Basingstoke, United KingdomInfectious Diseases and Microbiology Department, Hôpital Joseph Ducuing, Toulouse, FranceClinical Microbiology Department, Hôpital Saint Joseph, Paris, FrancePharmacy Department, Royal Free Hospital NHS Foundation Trust, London, United KingdomInstitute for Infectious Diseases, University of Bern, Bern, SwitzerlandDepartment of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, United KingdomClinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom<p>Dalbavancin is a lipoglycopeptide with a half-life of 14 d, significantly reducing the need for daily antibiotic dosing. Although dalbavancin is approved for acute bacterial skin and skin structure infections, its off-label use in complex musculoskeletal infection (MSKI) is increasing. Evidence on its effectiveness for MSKI, especially in facilitating early discharge for patients unsuitable for oral or OPAT (outpatient parenteral antimicrobial therapy) treatments, is limited.</p> <p><span id="page94"/>This multi-centre observational study aims to evaluate dalbavancin's role in facilitating discharge and improving clinical outcomes in MSKI. <strong>Method</strong>: this study included adult patients treated with dalbavancin between January 2017 and December 2022 across five hospitals in the UK and France. Data on patient demographics, clinical characteristics, microbiology and treatment outcomes were collected using a standardised form. The study also compared treatment costs between dalbavancin and hypothetical alternatives involving either inpatient care or OPAT. Clinical success was defined as the absence of definite failure based on the OVIVA (oral versus intravenous antibiotics) trial criteria. <strong>Results</strong>: a total of 39 patients were included, with a median age of 51 years (interquartile range (IQR) 40–72). Prosthetic joint infections (38 %) and septic arthritis (31 %) were the most common indications for dalbavancin use. The primary pathogens identified were <i>Staphylococcus aureus</i> (51 %) and coagulase-negative staphylococci (44 %). Dalbavancin was primarily chosen due to poor adherence or lack of OPAT options in 77 % of cases and for convenience in 23 %. In the necessity group, the use of dalbavancin resulted in a median cost saving of GBP 8894 per patient, and 31 inpatient days were avoided. Of the 32 patients (82 %) assigned a definite outcome, 72 % achieved clinical success. No significant adverse drug reactions were reported. <strong>Conclusion</strong>: this study fills an important evidence gap by demonstrating that dalbavancin is a viable and cost-effective option for MSKI patients that are unsuitable for oral or OPAT treatments. Dalbavancin facilitates early discharge, reduces hospital stays and achieves comparable clinical outcomes to conventional therapies.</p>https://jbji.copernicus.org/articles/10/93/2025/jbji-10-93-2025.pdf |
| spellingShingle | T. Azamgarhi S. Warren A. Scobie N. Karunaharan C. Perez-Sanchez R. Houghton S. Hassan J. Lourtet-Hascoët J. Lourtet-Hascoët H. Kershaw P. Sendi K. Saeed K. Saeed Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application Journal of Bone and Joint Infection |
| title | Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application |
| title_full | Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application |
| title_fullStr | Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application |
| title_full_unstemmed | Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application |
| title_short | Dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections: a multi-centre real-life application |
| title_sort | dalbavancin to facilitate early discharge in the treatment of complex musculoskeletal infections a multi centre real life application |
| url | https://jbji.copernicus.org/articles/10/93/2025/jbji-10-93-2025.pdf |
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