Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 11:30:101505.
doi: 10.1016/j.artd.2024.101505. eCollection 2024 Dec.

Dalbavancin Use in Bone and Joint Infections

Liam P Alderson  1 , Srivani Sanikommu  2 , Simon C Mears  3 , C Lowry Barnes  3 , Benjamin M Stronach  3 , Jeffrey B Stambough  3 , Jennifer McDonald  4 , Traci Motes  3 , Brett Bailey  5 , Ryan K Dare  4
Affiliations

Dalbavancin Use in Bone and Joint Infections

Liam P Alderson et al. Arthroplast Today. .

Abstract

Background: Dalbavancin (DAL) off-label use for treating bone and joint infections has increased especially as long-term intravenous access is not needed. Little is known about the effectiveness and safety of its use.

Methods: This retrospective, single-center, descriptive study included adults treated with DAL for bone or joint infections over a 4-year period (2019-2023). Patient demographics, infection type and location, pre-DAL antibiotic and surgical treatments, indication for DAL, and clinical outcomes were collected. Risk factor analysis for 1-year infection recurrence was performed.

Results: There were 58 patient encounters of bone and/or joint infections treated with DAL. The majority of patients were treated for osteomyelitis (81.0%) followed by native (8.6%) and peri-prosthetic (10.4%) joint infection. Fifty (86.2%) patients underwent surgical intervention, and 17 (68%) of the 25 patients with infected hardware had full hardware removal. The most common pathogen identified was Staphylococcus aureus (41; 70.7%), with methicillin-resistant Staphylococcus aureus isolated in 23 (40.0%) cases. Ten (17.2%) patients had recurrence within 1 year. Hardware removal was found to significantly decrease the risk of infection recurrence (P = .026). None of the peri-prosthetic joint infection patients had infection recurrence within 1 year.

Conclusions: Our findings support DAL as an effective treatment for bone and joint infection when combined with surgical debridement and hardware removal. Failure to remove infected hardware significantly increased the risk of infection recurrence within 1 year. Randomized controlled trials are needed to further support DAL as a novel treatment for orthopedic infections.

Keywords: Dalbavancin (DAL); Methicillin-resistant Staphylococcus aureus (MRSA); Osteomyelitis; Peri-prosthetic joint infection (PJI).

PubMed Disclaimer

References

    1. Lindgren V., Gordon M., Wretenberg P., Kärrholm J., Garellick G. Deep infection after total hip replacement: a method for national incidence surveillance. Infect Control Hosp Epidemiol. 2014;35:1491–1496. - PubMed
    1. Thompson O., W-Dahl A., Lindgren V., Gordon M., Robertsson O., Stefánsdóttir A. Similar periprosthetic joint infection rates after and before a national infection control program: a study of 45,438 primary total knee arthroplasties. Acta Orthop. 2022;93:3–10. - PMC - PubMed
    1. Ahmed S.S., Begum F., Kayani B., Haddad F.S. Risk factors, diagnosis and management of prosthetic joint infection after total hip arthroplasty. Expert Rev Med Dev. 2019;16:1063–1070. - PubMed
    1. Maffulli N., Papalia R., Zampogna B., Torre G., Albo E., Denaro V. The management of osteomyelitis in the adult. Surgeon. 2016;14:345–360. - PubMed
    1. Jha Y., Chaudhary K. Diagnosis and treatment modalities for osteomyelitis. Cureus. 2022;14 doi: 10.7759/cureus.30713. - DOI - PMC - PubMed

LinkOut - more resources