Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Otorhinolaryngology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
BMC Infect Dis. 2023 Oct 19;23(1):706. doi: 10.1186/s12879-023-08709-8.
Dalbavancin is a lipoglycopeptide antibiotic approved for treatment of skin and soft tissue infections, administered as a single or two-dose treatment. The extended half-life, good penetration into bone and synovial fluid, and bactericidal activity against gram-positive bacteria, including those in biofilm, make dalbavancin an appealing choice for treatment of bone and joint infections in outpatient settings. However, we present a rare case of ototoxicity associated with off-label extended dalbavancin treatment of a prosthetic joint infection.
A 55-year-old man with a prosthetic joint infection of the shoulder underwent off-label extended dalbavancin treatment, receiving a cumulative dose of 2500 mg. The patient experienced a gradual onset of hearing loss following the first dose, leading to a diagnosis of bilateral sensorineural hearing loss that persisted 1 year after dalbavancin was discontinued.
This case report highlights the importance of exercising caution when administering dalbavancin beyond approved dosing guidelines, and emphasizes the need for vigilance regarding the potential for ototoxicity.
达巴万星是一种糖肽类抗生素，获批用于治疗皮肤和软组织感染，可单剂或两剂治疗。其半衰期长，可良好穿透至骨骼和滑液，对包括生物膜内的革兰氏阳性菌具有杀菌活性，使达巴万星成为治疗门诊环境中骨骼和关节感染的一种有吸引力的选择。然而，我们报告了一例与达巴万星标签外延长治疗假体关节感染相关的罕见耳毒性病例。
一名 55 岁男性因肩假体关节感染接受了达巴万星标签外延长治疗，累积剂量为 2500mg。患者在首次用药后出现听力逐渐下降，导致双侧感音神经性听力损失，停药 1 年后仍持续存在。
本病例报告强调了在批准的用药指南之外使用达巴万星时要谨慎，并且需要警惕其潜在的耳毒性。
