A descriptive case series of the relationship between maintenance over time of conservative PK/PD efficacy thresholds of dalbavancin and clinical outcome in long-term treatment of staphylococcal osteoarticular infections
Abstract
OBJECTIVE
To describe the relationship between maintenance over time of pharmacokinetic/pharmacodynamic (PK/PD) dalbavancin efficacy thresholds and clinical outcome in a case series of patients who underwent therapeutic drug monitoring (TDM) during long-term treatment of staphylococcal osteoarticular infections (OIs).
METHODS
Patients who received two 1500 mg dalbavancin doses one week apart for documented staphylococcal OIs, underwent TDM assessment, and had clinical outcome assessable at follow-up were retrospectively included. Dalbavancin concentrations ≥4.02 and/or ≥8.04 mg/L were identified as conservative PK/PD efficacy thresholds. The percentage of time of the overall treatment period with dalbavancin concentrations above these efficacy thresholds was calculated and correlated with clinical outcome.
RESULTS
A total of 17 patients were retrieved. Long-term dalbavancin was used mainly for treating prosthetic joint infections (9/17; 52.9%). In 13/17 patients (76.5%), clinical outcome was assessable after at least 6-month follow-up and was always successful (100.0%). In 4/17 (23.5%) patients, clinical outcome is going favourably after a follow-up of 3.7, 4.8, 5.1 and 5.3 months, respectively. In most patients, both dalbavancin PK/PD efficacy thresholds were granted for most of treatment duration (%time ≥4.02 mg/L: 100% in 13 cases, 75-99.9% in 2 cases, 50-74.99% in other 2; %time ≥8.04 mg/L: 100% in 8 cases, 75-99.9% in 4 cases, 50-74.99% in other 4, and < 50% in 1 case).…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 17 participants or records.
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