Background and Importance Dalbavancin is a semi-synthetic lipoglycopeptide with activity against gram-positives, including methicillin-resistant Staphylococcus aureus, indicated for skin and soft tissue infections. Unlike other glycopeptides, it has an extremely long half-life, allowing for weekly or biweekly dosing.

Aim and Objectives The aim of the study was to evaluate the effectiveness and safety of dalbavancin in gram-positive infection treatment in patients at a tertiary-level hospital.

Material and Methods Retrospective, single-centre study. Patients receiving dalbavancin from September 2021 to August 2023 were included. Clinical and analytical data were obtained from medical records. Variables collected: gender, age, antibiotic allergies, type of infection, causative microorganism, previous antibiotic therapy. Regarding treatment: dosage, duration, diagnosis, concomitant antibiotics, clinical and microbiological resolution, adverse reactions (ARs) and discontinuation due to them. Clinical resolution was defined as absence of infection signs, and microbiological resolution as obtaining a negative culture.

Results 35 patients were included, with mean age (±SD) of 70 (±11.54) years, 60.7%male. Only one had antibiotic allergy (amoxicillin-clavulanate). All patients had received prior antibiotic treatment before dalbavancin, except one, average duration (±SD) of 20 (±8.5) days.

Dalbavancin was prescribed as targeted treatment except for two empiric cases. The indications were: endocarditis 60.0%; prosthetic infection 20.0%; pacemaker infection 8.6%; and the remaining 11.4% included osteomyelitis, septic pseudoarthritis, mycotic aneurysm, and mediastinitis (1 each).

Causative microorganisms Staphylococcus epidermidis 28.6%, Viridans-group Streptococcus 20.0%, Methicillin-sensitive S.aureus 14.3%, Enterococcus spp.11.4% (3 E.faecium and 1 E.faecalis), Clostridium spp.11.4%, Methicillin-resistant S.aureus 5.7%, Abiotrophia spp.2.9%.

Dosage regimen 48.6% (17) weekly regimen (initial dose 1000 mg, maintenance 500 mg); 34.3% (12) biweekly treatment (initial dose 1500 mg, maintenance 1000 mg); and 17.1% (6) single dose of 1500 mg. Mean duration (±SD) was 4.32 (±3.38) weeks. One patient received concomitant antibiotic treatment due to a polymicrobial infection.

Reasons for using dalbavancin was to facilitate discharge and avoid prolonged hospital stays in 27/35 patients, three failed to previous antibiotics, and five had ARs to previous antibiotics.

Clinical and microbiological remission was achieved in 85.7%. No patient experienced ARs to the drug.

Conclusion and Relevance In our experience, dalbavancin is effective and safe in gram-positive infections requiring prolonged treatments, such as endocarditis. Its pharmacokinetic characteristics enable outpatient-type administration that reduces patient‘s hospital stay, resulting in increased patient safety and quality of life, as well as significant cost savings in hospital expenses.

Conflict of Interest No conflict of interest.