Cooper Margaret M, Preslaski Candice R, Shihadeh Katherine C, Hawkins Kellie L, Jenkins Timothy C
Pharmacy Department, Denver Health Medical Center, Denver, Colorado, USA.
Division of Infectious Diseases, Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA.
Open Forum Infect Dis. 2021 Oct 27;8(11):ofab486. doi: 10.1093/ofid/ofab486. eCollection 2021 Nov.
Off-label use of dalbavancin for deep-seated and endovascular infections has been increasing. We performed a scoping review to evaluate the evidence for use of multiple-dose dalbavancin regimens as the predominant therapy for these indications. Predominant therapy was defined as use of dalbavancin without other concurrent antibiotics for more than half of the total treatment duration. Fifteen publications were identified; 2 were small, open-label randomized controlled trials and the remainder were retrospective observational studies or case reports. A total of 144 cases from these publications met eligibility criteria for inclusion in this review. Types of infections included osteoarticular infections, catheter-related or complicated bloodstream infections, and infective endocarditis. Overall, the evidence for use of multiple-dose regimens of dalbavancin for deep-seated and endovascular infections is limited by a paucity of data from controlled trials, heterogeneity of dosing regimens, and a lack of standardized clinical outcomes.
达巴万星用于深部和血管内感染的超说明书用药情况一直在增加。我们进行了一项范围综述，以评估使用多剂量达巴万星方案作为这些适应症主要治疗方法的证据。主要治疗定义为在总治疗疗程的一半以上时间内使用达巴万星且无其他同时使用的抗生素。共识别出15篇文献；2篇为小型开放标签随机对照试验，其余为回顾性观察性研究或病例报告。这些文献中的144例病例符合纳入本综述的资格标准。感染类型包括骨关节炎感染、导管相关或复杂性血流感染以及感染性心内膜炎。总体而言，由于对照试验数据匮乏、给药方案的异质性以及缺乏标准化的临床结局，多剂量达巴万星方案用于深部和血管内感染的证据有限。
