Ioannou Petros, Wolff Nora, Mathioudaki Anna, Spanias Christos, Spernovasilis Nikolaos, Kofteridis Diamantis P
School of Medicine, University of Crete, 71003 Heraklion, Greece.
Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece.
Antibiotics (Basel). 2023 Jul 19;12(7):1205. doi: 10.3390/antibiotics12071205.
Dalbavancin is a semisynthetic lipoglycopeptide, which possesses great potential for bactericidal activity similar to antimicrobials with the same mechanism of action, such as vancomycin and teicoplanin. Due to its very prolonged half-life, it can be used in a single or two-dose regimen to treat infections by Gram-positive microorganisms, even resistant ones, such as methicillin-resistant (MRSA). Currently, it is approved only for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). The aim of this study was to investigate the clinical and microbiological characteristics of patients to whom dalbavancin was administered at the University Hospital of Heraklion and evaluate its use in regard to the COVID-19 pandemic. In total, 146 patients were included in this retrospective cohort study evaluating the use of dalbavancin from the first time it was used in 2017 until the end of 2022. The median age was 68 years (range: 21-96 years), and 86 (59%) patients were male. The most common indications for dalbavancin use were osteoarticular infections in 43%, followed by ABSSSIs in 37%, and cardiovascular infections in 10%. Dalbavancin was used empirically in one out of three patients, most commonly with the indication of ABSSSIs, and most commonly in the post-COVID-19 era. The most frequently isolated pathogens were coagulase-negative staphylococci in 70%, in 27%, spp. in 22%, and spp. in 8%, while one out of three infections were polymicrobial. In 12% of patients, the infection was not cured, but no patients died. For patients with ABSSSIs, endocarditis and vascular infections, and bacteremia, the cure rates were more than 90%, and in osteoarticular infections, the cure rate was 76%. Thus, dalbavancin has great potential for use in complicated and invasive infections that may require prolonged intravenous antimicrobial treatment. However, further studies are required to formally investigate its role in such infections.
达巴万星是一种半合成脂糖肽，具有与作用机制相同的抗菌药物（如万古霉素和替考拉宁）相似的强大杀菌活性潜力。由于其半衰期极长，它可采用单剂量或双剂量方案用于治疗革兰氏阳性微生物感染，甚至是耐药微生物感染，如耐甲氧西林金黄色葡萄球菌（MRSA）。目前，它仅被批准用于治疗急性细菌性皮肤和皮肤结构感染（ABSSSIs）。本研究的目的是调查在伊拉克利翁大学医院接受达巴万星治疗的患者的临床和微生物学特征，并评估其在新冠疫情期间的使用情况。在这项回顾性队列研究中，共纳入了146例患者，评估了达巴万星自2017年首次使用至2022年底的使用情况。中位年龄为68岁（范围：21 - 96岁），86例（59%）患者为男性。使用达巴万星最常见的适应证是骨关节炎感染（43%），其次是ABSSSIs（37%），心血管感染（10%）。三分之一的患者经验性使用达巴万星，最常见的适应证是ABSSSIs，且最常见于新冠疫情后时代。最常分离出的病原体是凝固酶阴性葡萄球菌（70%）、金黄色葡萄球菌（27%）、肠球菌属（22%）和链球菌属（8%），三分之一的感染为多微生物感染。12%的患者感染未治愈，但无患者死亡。对于ABSSSIs、心内膜炎和血管感染以及菌血症患者，治愈率超过90%，在骨关节炎感染中，治愈率为76%。因此，达巴万星在可能需要长期静脉抗菌治疗的复杂和侵袭性感染中具有很大的使用潜力。然而，需要进一步研究来正式调查其在这类感染中的作用。
