Internal Medicine, University of Campania 'L. Vanvitelli', Caserta, Italy.
Units of Infectious and Transplant Medicine.
J Chemother. 2021 Jul;33(4):256-262. doi: 10.1080/1120009X.2020.1823119. Epub 2020 Oct 19.
Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive cocci, needing a 4-6 weeks antibiotic course. Dalbavancin is a lipoglycopeptide active on gram-positive microorganisms, with a unique pharmacokinetic profile. We describe our experience with dalbavancin to complete the intravenous antibiotic regimen for difficult-to-treat IE cases due to gram-positive bacteria. We treated 10 severely ill patients, each presenting several comorbidities. Seven patients were microbiologically cured from IE, but two patients experienced IE relapse due to the same microrganism. Short-term mortality after dalbavancin was nil, but late mortality (within 1 year of hospital discharge) was 60%. No death was related to dalbavancin therapy. Treatment was generally well tolerated. Dalbavancin may be an option to complete IE treatment in selected cases, once blood culture clearance and improvement of clinical conditions under standard therapy is reached, allowing shortening of hospitalization.
感染性心内膜炎（IE）是一种危及生命的疾病，主要由革兰阳性球菌引起，需要 4-6 周的抗生素疗程。达巴万星是一种对革兰阳性微生物具有活性的糖肽类抗生素，具有独特的药代动力学特征。我们描述了我们使用达巴万星治疗因革兰阳性菌引起的治疗困难的 IE 病例的经验，以完成静脉内抗生素治疗方案。我们治疗了 10 名重病患者，每位患者都有多种合并症。7 名患者的 IE 经微生物学治愈，但有 2 名患者因相同的微生物发生 IE 复发。达巴万星治疗后短期死亡率为零，但 1 年内的晚期死亡率为 60%。没有死亡与达巴万星治疗有关。治疗总体上耐受性良好。一旦达到血培养清除和标准治疗下临床状况的改善，达巴万星可能是治疗选定病例 IE 的一种选择，可以缩短住院时间。
