Journal
DRUG DESIGN DEVELOPMENT AND THERAPY
Volume 15, Issue -, Pages 3349-3378Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/DDDT.S313756
Keywords
dalbavancin; osteomyelitis; endocarditis; long-term suppressive therapy; PK; PD properties; COVID-19
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Funding
- Angelini S.P.A.
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Dalbavancin is a novel, long-acting lipoglycopeptide with excellent in vitro activity against multidrug-resistant Gram-positives, and evidence supports its efficacy in long-term therapy for osteomyelitis, prosthetic joint infections, endocarditis, and bloodstream infections. Its unique pharmacokinetic/pharmacodynamic properties make it a valuable alternative in treating long-term Gram-positive infections, especially in scenarios like COVID-19 where hospitalization and territorial medicine empowerment are unavoidable.
Dalbavancin is a novel, long-acting lipoglycopeptide characterized by a long elimination half-life coupled with excellent in vitro activity against multidrug-resistant Gram-positives. Although it is currently approved only for the treatment of acute bacterial skin and skin structure infections, an ever-growing amount of evidence supports the efficacy of dalbavancin as a long-term therapy in osteomyelitis, prosthetic joint infections, endocar-ditis, and bloodstream infections. This article provides a critical reappraisal of real-world use of dalbavancin for off-label indications. A search strategy using specific keywords (dalba-vancin, osteomyelitis, endocarditis, long-term suppressive therapy, bloodstream infection, pharmacokinetic/pharmacodynamic profile) until April 2021 was performed on the PubMed-MEDLINE database. As for other novel antibiotics, a conundrum between approved indica-tions and potential innovative therapeutic uses has emerged for dalbavancin as well. The promising efficacy in challenging scenarios (i.e., osteomyelitis, endocarditis, prosthetic joint infections), coupled with the unique pharmacokinetic/pharmacodynamic properties, makes dalbavancin a valuable alternative to daily in-hospital intravenous or outpatient antimicrobial regimens in the treatment of long-term Gram-positive infections. This makes dalbavancin valuable in the current COVID-19 scenario, in which hospitalization and territorial medicine empowerment are unavoidable.
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