Case Series: Use of Dalbavancin for Invasive Gram-Positive Infection in Children

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Pharmacology

Background:

• Dalbavancin, a lipoglycopeptide, is approved for pediatric skin/soft tissue infections.
• Limited pediatric data exist beyond pharmacokinetic studies and case reports.
• Adult data cover skin/soft tissue, osteoarticular, and bloodstream infections.

Purpose of the Study:

• To describe clinical and microbiologic outcomes of dalbavancin use in pediatric patients.
• To evaluate dalbavancin's efficacy and safety in various invasive Gram-positive infections.
• To identify patient populations where dalbavancin may be a valuable therapeutic option.

Main Methods:

• Retrospective chart review of 20 pediatric patients receiving dalbavancin.
• Study conducted across two pediatric hospitals between August 2020 and July 2025.
• Inclusion criteria: any indication for dalbavancin use.

Main Results:

• Dalbavancin used in 20 pediatric patients (2 weeks to 18 years).
• Common pathogens included Staphylococcus aureus; all isolates were susceptible.
• Indications included contraindications to other therapies and IV access challenges.
• Most patients recovered without complications; no microbiologic failure observed.

Conclusions:

• Dalbavancin appears safe and effective for specific invasive pediatric Gram-positive infections.
• It serves as a viable alternative for patients with contraindications to standard parenteral therapy.
• Further pediatric trials are recommended, particularly for indications beyond skin/soft tissue infections.