Clinical, microbiological and laboratory predictors of on- and off-label dalbavancin treatment failure

• DOI: 10.1016/j.jgar.2025.05.014
• Publication Date: 2025-05-15T23:37:10Z
• Authors: Maria Mazzitelli; Daniele Mengato; Vincenzo Scaglione; Elisabetta Maria ...; Elena Barzizza; Luigi Salmaso; Francesca Venturini; Annamaria Cattelan
• Keywords: Dalbavancin; Off-label use

Data about risk factors for treatment failure (TF) to dalbavancin are lacking. Our aim was investigate the clinical, microbiological and laboratory predictors of TF in both on- off-label treatments. We included all patients who received at least one dose our center from January 2018 June 2024 with available data on follow-up, collecting clinical parameters. defined as need readmission, emergency department access, or death within 90 days after treatment. Factors correlating mortality rate were assessed by multivariable analyses Kaplan Meier curves. Three-hundred-fifty-one included, mostly males (60.9%), median age 64 years (IQR:49.5-75.5), 55.3% receiving department/outpatient setting, 44.7% an early discharge, 54.9% cases off-label. The main indications osteomyelitis, prosthetic infections, endocarditis (17.1%, 8.3%, 7.7%). In 53.3% cases, a isolate (MRSA 49.2% cases). Overall, 19.4%. analysis showed that intravenous drug use (HR:7.99, p<0.001), diabetes (HR:6.1, obesity (HR: 4.5, cancer (HR:5.3, HIV (HR:4.88, levels CRP initiation (HR=1.01, p<0.001, HR=0.72, p=0.02) associated TF. Additionally, duration antibiotic therapy before being discharged influenced outcomes group (HR=0.52, p=0.02). observed high, particularly uses among individuals multiple comorbidities use. More evidences needed better define optimal patient profile effective