Real world use of dalbavancin for bone and joint infections: a retrospective case series in adults and children
Abstract
BACKGROUND: Bone and joint infections (BJIs) often require prolonged parenteral therapy, with challenges of hospitalization and vascular access [1–4]. Dalbavancin, a long-acting lipoglycopeptide, enables once-weekly dosing [7–10]. This study reports real-world outcomes of dalbavancin, used off-label in adults and children with BJIs. METHODS: We conducted a retrospective, single-centre case series of 14 consecutive patients (10 adults, 4 paediatric) with Gram-positive BJIs treated between January 2024 and April 2025. All received ≥ 3 weekly dalbavancin doses (definitive therapy), with oral step-down to complete a total treatment course of 8–12 weeks. Demographics, microbiology, therapy and outcomes were assessed with ≥ 6 months follow-up. MICs were tested using E-test strips; results interpreted using CLSI 2021 breakpoints [12]. Off-label nature of therapy was noted. RESULTS: Median age was 36 years (range 5–80), including 4 paediatric patients. MRSA accounted for 57% of the isolates. Dalbavancin MICs were consistently low (≤ 0.064 mg/L) [12, 14]. Median prior antibiotic exposure was 10 days before switch over to dalbavancin. All patients achieved end-of-therapy cure defined as the resolution of signs and symptoms of infection with no requirement for additional antibiotics for the primary infection and no recurrence. At 6 months, 92.9% patients remained infection-free while one patient who was still under follow up, showed sustained clinical improvement. Therapy was well…
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: 14 participants or records.
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