Navarro-Jiménez Gema, Fuentes-Santos Cristina, Moreno-Núñez Leonor, Alfayate-García Jesús, Campelo-Gutierrez Carolina, Sanz-Márquez Sira, Pérez-Fernández Elia, Velasco-Arribas María, Hervás-Gómez Rafael, Martín-Segarra Oriol, Losa-García Juan Emilio
Servicio de Medicina interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
Escuela Internacional de Doctorado. Universidad Rey Juan Carlos, Móstoles, Madrid, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2022 Jun-Jul;40(6):296-301. doi: 10.1016/j.eimce.2022.03.001. Epub 2022 Apr 27.
To describe the clinical experience with dalbavancin in the treatment of diabetic foot infection in a multidisciplinary unit of a second level hospital.
A retrospective, descriptive study was made with all patients with diabetic foot infection treated with dalbavancin in the Diabetic Foot Unit of Hospital Universitario Fundación Alcorcón, covering the period from September 2016 to December 2019. Demographic parameters and comorbidities, characteristics of the infection and treatment with dalbavancin were recorded. The cure rate is estimated at 90 days after finishing the treatment.
A total of 23 patients with diabetic foot infection (osteomyelitis) started treatment with dalbavancin, 19 were men and the mean age was 65 years. The microorganisms most frequently isolated for the indication of treatment with dalbavancin were Staphylococcus aureus (11) and Corynebacterium striatum (7). Dalbavancin was used as a second choice therapy in 22 cases, in 11 due to toxicity from other antibiotics. The median duration of treatment was 5 (4-7) weeks; the most frequent dose of dalbavancin (8 patients) was 1000 mg followed by 500 mg weekly for 5 weeks. 3 patients presented mild side effects (nausea and gastrointestinal discomfort). At 90 days after completion of dalbavancin therapy, 87% (20) of the patients were cured (95% CI: 65.2%-94.52%).
Patients with osteomyelitis due to gram-positive microorganisms who received as part of the multidisciplinary antibiotic treatment with dalbavancin, had a high rate of cure with adequate tolerance and few side effects. Dalbavancin offers a safe alternative in treating deep diabetic foot infection.
描述在一家二级医院的多学科科室中使用达巴万星治疗糖尿病足感染的临床经验。
对2016年9月至2019年12月期间在阿尔科孔基金会大学医院糖尿病足科室接受达巴万星治疗的所有糖尿病足感染患者进行回顾性描述性研究。记录人口统计学参数和合并症、感染特征以及达巴万星治疗情况。在治疗结束90天后估算治愈率。
共有23例糖尿病足感染（骨髓炎）患者开始使用达巴万星治疗，其中19例为男性，平均年龄65岁。达巴万星治疗指征中最常分离出的微生物是金黄色葡萄球菌（11例）和纹带棒状杆菌（7例）。22例患者将达巴万星用作二线治疗，其中11例是由于其他抗生素的毒性。治疗的中位持续时间为5（4 - 7）周；达巴万星最常用剂量（8例患者）为1000mg，随后每周500mg，共5周。3例患者出现轻度副作用（恶心和胃肠道不适）。在完成达巴万星治疗90天后，87%（20例）患者治愈（95%置信区间：65.2% - 94.52%）。
接受达巴万星作为多学科抗生素治疗一部分的革兰氏阳性微生物所致骨髓炎患者，治愈率高，耐受性良好且副作用少。达巴万星为治疗糖尿病足深部感染提供了一种安全的选择。
