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Dalbavancin for Bone and Joint Infections: A Two-Center Greek Real-World Retrospective Study.

Christina Petropoulou1, Petros Ioannou2, Georgios Eleftherakis1

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Dalbavancin offers a simplified treatment for challenging bone and joint infections, showing high efficacy and safety. This long-acting antibiotic reduces hospitalization and complications, proving effective in complex cases.

Keywords:
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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Orthopedics

Background:

  • Bone and joint infections (BJIs) pose significant therapeutic challenges, often necessitating prolonged intravenous (IV) antibiotic therapy and hospitalization.
  • Dalbavancin, a lipoglycopeptide with extended activity, presents a potential alternative for simplifying BJI treatment regimens.

Purpose of the Study:

  • To evaluate the efficacy and safety of dalbavancin in treating various BJIs in a real-world clinical setting.
  • To assess dalbavancin's effectiveness as both monotherapy and combination therapy for complex infections.

Main Methods:

  • Retrospective analysis of 83 patients treated with dalbavancin for osteomyelitis, spondylodiscitis, septic arthritis, or prosthetic joint infections between 2022-2024.
  • Data collected on patient demographics, comorbidities, infection types, causative pathogens, treatment regimens, and clinical outcomes.
  • Adverse events and clinical cure rates at 90 and 180 days were recorded.

Main Results:

  • The study included 83 patients (mean age 69 years) with diverse BJIs, predominantly vertebral osteomyelitis/spondylodiscitis (48.2%).
  • Common pathogens included *Staphylococcus aureus* (38.4%) and enterococci (25%). Dalbavancin was used as monotherapy (32.4%) or combination therapy (67.6%).
  • High clinical cure rates were observed: 90.4% at 90 days and 92.8% at 180 days, with comparable efficacy between monotherapy and combination arms. Adverse events were infrequent (4.8%).

Conclusions:

  • Dalbavancin demonstrates high efficacy and a favorable safety profile for treating complex bone and joint infections.
  • Its long half-life simplifies treatment, reduces the need for prolonged IV access, and minimizes hospitalization, making it a valuable option, especially where outpatient parenteral therapy is limited.