Barber Katie E, Tirmizi Amir, Finley Richard, Stover Kayla R
Department of Pharmacy Practice, School of Pharmacy, University of Mississippi, Jackson, MS, USA.
Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA.
J Pharmacol Pharmacother. 2017 Apr-Jun;8(2):77-79. doi: 10.4103/jpp.JPP_2_17.
Dalbavancin is a lipoglycopeptide with a long half-life that allows infrequent dosing. It is indicated for the treatment of acute bacterial skin and skin structure infections caused by susceptible organisms, including and methicillin-resistant (MRSA). Although this agent has been used off-label clinically, there are minimal data in infections outside the current indications. We report a case of a 28-year-old nonadherent male with HIV presenting with pneumonia due to MRSA that was treated with dalbavancin. The patient was admitted to the hospital with classic pneumonia symptoms, and sputum cultures and bronchoalveolar lavage grew MRSA. Other infections were ruled out. The patient was initially treated with vancomycin, but subtherapeutic concentrations prompted a change to dalbavancin upon discharge. The patient was readmitted 11 days later with the complaints of hemoptysis and shortness of breath, with unchanged imaging. However, no evidence of MRSA was found at this time. Utility of dalbavancin for other disease states has profound implications, particularly in patients with poor medication adherence.
达巴万星是一种具有长半衰期的脂糖肽,这使得给药频率较低。它适用于治疗由易感微生物引起的急性细菌性皮肤和皮肤结构感染,包括耐甲氧西林金黄色葡萄球菌(MRSA)。尽管该药物已在临床中被超适应证使用,但在当前适应证以外的感染方面数据极少。我们报告一例28岁不依从治疗的男性HIV患者,因MRSA导致肺炎,接受了达巴万星治疗。该患者因典型的肺炎症状入院,痰培养和支气管肺泡灌洗培养出MRSA。排除了其他感染。患者最初接受万古霉素治疗,但血药浓度未达治疗水平,出院时改用达巴万星。11天后患者因咯血和气短再次入院,影像学表现无变化。然而,此时未发现MRSA感染迹象。达巴万星在其他疾病状态下的应用具有深远意义,尤其是在药物依从性差的患者中。