Dalbavancin for the Treatment of Prosthetic Joint Infections: A Narrative Review

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2021 Jun 2

PMID 34072670

Citations 11

Authors

Luis Buzon-Martin

I Zollner-Schwetz

Selma Tobudic

Emilia Cercenado

Jaime Lora-Tamayo

Affiliations

Soon will be listed here.

Abstract

Dalbavancin (DAL) is a lipoglycopeptide with bactericidal activity against a very wide range of Gram-positive microorganisms. It also has unique pharmacokinetic properties, namely a prolonged half-life (around 181 h), which allows a convenient weekly dosing regimen, and good diffusion in bone tissue. These features have led to off-label use of dalbavancin in the setting of bone and joint infection, including prosthetic joint infections (PJI). In this narrative review, we go over the pharmacokinetic and pharmacodynamic characteristics of DAL, along with published in vitro and in vivo experimental models evaluating its activity against biofilm-embedded bacteria. We also examine published experience of osteoarticular infection with special attention to DAL and PJI.

Citing Articles

Bridging the Gap: A Systematic Review with Expert Opinion on the Use of Dalbavancin for In-Label and Off-Label Indications in Pediatric Patients.

Caselli D, Arico M, Castagnola E, Gatti M Antibiotics (Basel). 2025; 14(2).

PMID: 40001365 PMC: 11852066. DOI: 10.3390/antibiotics14020121.

Dalbavancin Use in Bone and Joint Infections.

Alderson L, Sanikommu S, Mears S, Barnes C, Stronach B, Stambough J Arthroplast Today. 2025; 30:101505.

PMID: 39959367 PMC: 11827072. DOI: 10.1016/j.artd.2024.101505.

The MIC distribution of dalbavancin differs between different coagulase-negative staphylococci.

Svensson S, Hagstedt P, Soderquist B JAC Antimicrob Resist. 2024; 6(2):dlae063.

PMID: 38601789 PMC: 11004784. DOI: 10.1093/jacamr/dlae063.

New Frontier on Antimicrobial Therapy: Long-Acting Lipoglycopeptides.

Siciliano V, Sangiorgi F, Del Vecchio P, Vahedi L, Gross M, Saviano A Pathogens. 2024; 13(3).

PMID: 38535533 PMC: 10975219. DOI: 10.3390/pathogens13030189.

Ototoxicity associated with extended dalbavancin treatment for a shoulder prosthetic joint infection.

Lange A, Thunberg U, Soderquist B BMC Infect Dis. 2023; 23(1):706.

PMID: 37858087 PMC: 10588017. DOI: 10.1186/s12879-023-08709-8.

References

Cavaleri M, Riva S, Valagussa A, Guanci M, Colombo L, Dowell J . Pharmacokinetics and excretion of dalbavancin in the rat. J Antimicrob Chemother. 2005; 55 Suppl 2:ii31-5. DOI: 10.1093/jac/dki006. View

Solon E, Dowell J, Lee J, King S, Damle B . Distribution of radioactivity in bone and related structures following administration of [14C]dalbavancin to New Zealand white rabbits. Antimicrob Agents Chemother. 2007; 51(8):3008-10. PMC: 1932505. DOI: 10.1128/AAC.00020-07. View

Andes D, Craig W . In vivo pharmacodynamic activity of the glycopeptide dalbavancin. Antimicrob Agents Chemother. 2007; 51(5):1633-42. PMC: 1855559. DOI: 10.1128/AAC.01264-06. View

Malabarba A, Goldstein B . Origin, structure, and activity in vitro and in vivo of dalbavancin. J Antimicrob Chemother. 2005; 55 Suppl 2:ii15-20. DOI: 10.1093/jac/dki005. View

Lampejo T . Dalbavancin and telavancin in the treatment of infective endocarditis: a literature review. Int J Antimicrob Agents. 2020; 56(3):106072. DOI: 10.1016/j.ijantimicag.2020.106072. View

Wunsch S, Krause R, Valentin T, Prattes J, Janata O, Lenger A . Multicenter clinical experience of real life Dalbavancin use in gram-positive infections. Int J Infect Dis. 2019; 81:210-214. DOI: 10.1016/j.ijid.2019.02.013. View

Buzon Martin L, Mora Fernandez M, Perales Ruiz J, Ortega Lafont M, Alvarez Paredes L, Moran Rodriguez M . Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: A proposal for a low dose strategy. A retrospective cohort study. Rev Esp Quimioter. 2019; 32(6):532-538. PMC: 6913079. View

Darouiche R, Mansouri M . Dalbavancin compared with vancomycin for prevention of Staphylococcus aureus colonization of devices in vivo. J Infect. 2005; 50(3):206-9. DOI: 10.1016/j.jinf.2004.05.006. View

Barnea Y, Lerner A, Aizic A, Navon-Venezia S, Rachi E, Dunne M . Efficacy of dalbavancin in the treatment of MRSA rat sternal osteomyelitis with mediastinitis. J Antimicrob Chemother. 2015; 71(2):460-3. DOI: 10.1093/jac/dkv357. View

10.

Di Pilato V, Ceccherini F, Sennati S, DAgostino F, Arena F, DAtanasio N . In vitro time-kill kinetics of dalbavancin against Staphylococcus spp. biofilms over prolonged exposure times. Diagn Microbiol Infect Dis. 2019; 96(2):114901. DOI: 10.1016/j.diagmicrobio.2019.114901. View

11.

Pizzuti A, Murray E, Wagner J, Gaul D, Bland C, Jones B . Financial Analysis of Dalbavancin for Acute Bacterial Skin and Skin Structure Infections for Self-Pay Patients. Infect Dis Ther. 2020; 9(4):1043-1053. PMC: 7680485. DOI: 10.1007/s40121-020-00347-w. View

12.

Cercenado E . [Antimicrobial spectrum of dalbavancin. Mechanism of action and in vitro activity against Gram-positive microorganisms]. Enferm Infecc Microbiol Clin. 2017; 35 Suppl 1:9-14. DOI: 10.1016/S0213-005X(17)30029-0. View

13.

Boucher H, Wilcox M, Talbot G, Puttagunta S, Das A, Dunne M . Once-weekly dalbavancin versus daily conventional therapy for skin infection. N Engl J Med. 2014; 370(23):2169-79. DOI: 10.1056/NEJMoa1310480. View

14.

Murillo O, Pachon M, Euba G, Verdaguer R, Carreras M, Cabellos C . Intracellular antimicrobial activity appearing as a relevant factor in antibiotic efficacy against an experimental foreign-body infection caused by Staphylococcus aureus. J Antimicrob Chemother. 2009; 64(5):1062-6. DOI: 10.1093/jac/dkp326. View

15.

Leighton A, Gottlieb A, Dorr M, Jabes D, Mosconi G, VanSaders C . Tolerability, pharmacokinetics, and serum bactericidal activity of intravenous dalbavancin in healthy volunteers. Antimicrob Agents Chemother. 2004; 48(3):940-5. PMC: 353075. DOI: 10.1128/AAC.48.3.940-945.2004. View

16.

Tobudic S, Forstner C, Burgmann H, Lagler H, Ramharter M, Steininger C . Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna. Clin Infect Dis. 2018; 67(5):795-798. DOI: 10.1093/cid/ciy279. View

17.

Dinh A, Duran C, Pavese P, Khatchatourian L, Monnin B, Bleibtreu A . French national cohort of first use of dalbavancin: A high proportion of off-label use. Int J Antimicrob Agents. 2019; 54(5):668-672. DOI: 10.1016/j.ijantimicag.2019.08.006. View

18.

Sader H, Streit J, Mendes R . Update on the in vitro activity of dalbavancin against indicated species (Staphylococcus aureus, Enterococcus faecalis, β-hemolytic streptococci, and Streptococcus anginosus group) collected from United States hospitals in 2017-2019. Diagn Microbiol Infect Dis. 2020; 99(1):115195. DOI: 10.1016/j.diagmicrobio.2020.115195. View

19.

Ramirez Hidalgo M, Jover-Saenz A, Garcia-Gonzalez M, Barcenilla-Gaite F . Dalbavancin treatment of prosthetic knee infection due to oxacillin-resistant Staphylococcus epidermidis. Enferm Infecc Microbiol Clin (Engl Ed). 2017; 36(2):142-143. DOI: 10.1016/j.eimc.2017.04.009. View

20.

Nicolau D, Sun H, Seltzer E, Buckwalter M, Dowell J . Pharmacokinetics of dalbavancin in plasma and skin blister fluid. J Antimicrob Chemother. 2007; 60(3):681-4. DOI: 10.1093/jac/dkm263. View