Dalbavancin in Bone and Joint Infections: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Information Sources and Search Strategy
2.3. Selection and Data Collection Process
2.4. Data Items
3. Results
3.1. Study Selection and Search Results
3.2. Results of Synthesis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Ethical Approval
References
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First Author | Ref. | N. of Patients | Type of the Study | Type of Infection (n) | Aetiology (n) | Outcome (n) | DBV Dosage (n) | N. Administrations (n) |
---|---|---|---|---|---|---|---|---|
Rappo U, et al. | [15] | 70 | Randomized controlled trial | Osteomyelitis (70) | S. aureus (42) CoNS (14) Enterococcus spp. (8) Streptococcus spp. (3) Other Gram-positive (13) Gram-negative and fungi (3) | Clinical cure (63) Clinical cure after different therapy (1) Lost to FU (2) Unrelated death (1) NA (3) | 1500 mg (70) | 1 dose (3) 2 doses, 1 week apart (67) |
Morata L, et al. | [16] | 19 | Retrospective | Osteomyelitis (12) Arthritis or spondylodiscitis (7) | S. aureus (10) CoNS (4) Enterococcus spp. (2) Streptococcus spp. (3) Other Gram+ (2) | Clinical cure (17) Clinical failure (1) Relapse (1) | NA | NA |
Almangour TA, et al. | [20] | 27 | Retrospective | Osteomyelitis (16) Spondylodiscitis (14) | S. aureus (27) CoNS (1) Streptococcus spp. (2) Gram-negative and fungi (1) | Clinical cure (24) Clinical failure (1) NA (2) | 1500 mg (11) 1000 + 500 mg (15) 2000 + 500 mg (1) | 1 dose (6) 2 doses, 1 week apart (6) 3 doses > 1 week apart (1) 3 doses, 1 week apart (2) 4 doses,1 week apart (4) 4 doses > 1 week apart (19) >4 doses (7) |
Stroffolini G, et al. | [21] | 25 | Prospective | Osteomyelitis (9) Spondylodiscitis (6) Arthritis (3) | NA | Clinical cure (9) NA (16) | 1500 mg (25) | 1 dose (3) 2 doses, 1 week apart (9) NA (13) |
Ramadan MS, et al. | [22] | 13 | Retrospective | Spondylodiscitis (13) | S. aureus (6) CoNS (4) Other Gram-positive (1) Gram-negative and fungi (2) | Clinical cure (8) Relapse (5) | 1500 mg (12) 1000 + 500 mgfor 5 times (1) | 2 doses, 1 week apart (12) >4 doses (1) |
Brescini L, et al. | [23] | 13 | Retrospective | Osteomyelitis (8) Arthritis (5) | NA | NA (13) | NA | NA |
De Nicolò A, et al. | [24] | 10 | Prospective | Osteomyelitis (4) Spondylodiscitis (3) Arthritis (3) | S. aureus (7) CoNS (2) Streptococcus spp. (1) | NA (10) | 1500 mg (10) | 1 dose (3) 2 doses, 1 week apart (7) |
Navarro-Jiménez G, et al. | [25] | 23 | Retrospective | Osteomyelitis (23) | S. aureus (12) Other Gram-positive (7) CoNS (3) Enterococcus spp. (1) | Clinical cure (20) Clinical failure (3) | 1000 + 500 mg for 5 times (8) 1000 + 500 + 500 + 500 mg (1) 1000 + 500 mg for 9 times (1) 1500 mg (9) 1000 mg (1) 750 mg (1) 1500 + 500 mg (2) | 1 dose (5) 2 doses, 1 week apart (5) 3 doses, 1 week apart (2) 4 doses, 1 week apart (1) >4 doses (10) |
Tobudic S, et al. | [26] | 38 | Retrospective | Osteomyelitis (20) Spondylodiscitis (14) Septic arthritis (4) | NA | Clinical cure (19) Clinical failure (7) Clinical cure after different therapy (8) NA (4) | 1000 + 500 (6) 1500 + 1000 mg (28) 1500 + 1500 mg (4) | NA |
Cain AR, et al. | [18] | 42 | Retrospective | Osteomyelitis (42) | S. aureus (23) NA (19) | Clinical cure (20) Relapse (13) Clinical failure (9) | 1500 mg (42) | 2 doses, 1 week apart (42) |
Cojutti PG, et al. | [27] | 27 | Retrospective | Osteomyelitis (16) Spondylodiscitis (9) Arthritis (2) | NA | NA (27) | 1000 mg (NA) 1500 mg (NA) | NA |
Cojutti PG, et al. | [11] | 2 | Prospective | Spondylodiscitis (1) Arthritis (1) | S. aureus (1) NA (1) | Clinical cure (1) Relapse (1) | 1500 mg (2) | 2 doses, 1 week apart (2) |
Lueking R, et al. | [28] | 19 | Retrospective | Osteomyelitis (15) Arthritis (4) | MSSA (1) NA (18) | Clinical cure (18) Relapse (1) | 1500 + 1500 (1) NA (18) | 2 doses, 1 week apart (1) NA (14) |
Tuan JJ, et al. | [29] | 23 | Retrospective | Osteomyelitis (21) Arthritis (2) | NA | Clinical cure (21) Clinical failure (1) Death from BJIs (1) | NA | NA |
Mazzitelli M, et al. | [30] | 14 | Retrospective | Spondylodiscitis (14) | S. aureus (14) | Clinical cure (14) | 1500 mg (14) | 3 doses >1 week apart (7) 4 doses > 1 week apart (5) |
Almangour TA, et al. | [31] | 9 | Retrospective | Osteomyelitis (6) Spondylodiscitis (3) | S. aureus (9) | Clinical cure (9) | NA (9) | NA |
Dinh A, et al. | [17] | 48 | Retrospective | NA | NA | Clinical cure (35) Clinical failure (11) NA (2) | 1000 mg (2) 1500 mg (37) 1500 + 1000 mg (1) 1500 + 500 mg (2) 1000 + 500 + 500 + 500 mg (6) | 1 dose (5) 2 doses > 1 week apart (4) 2 doses, 1 week apart (30) 3 doses, 1 week apart (1) 4 doses > 1 week apart (3) >4 doses (5) |
Loupa CV, et al. | [32] | 1 | Case report | Osteomyelitis (1) | Enterococcus spp. (1) | Lost at FU (1) | 1500 mg (1) | 2 doses > 1 week apart (1) |
Bork JT, et al. | [33] | 14 | Retrospective | Osteomyelitis (13) Arthritis (1) | NA | Clinical cure (6) Clinical failure (4) Lost to FU (3) Unrelated death (1) | NA | NA |
Ritchie H, et al. | [34] | 1 | Case report | Spondylodiscitis (1) | S. aureus (1) | Clinical cure after different therapy (1) | 1500 mg (1) | 1 dose (1) |
Almangour TA, et al. | [35] | 1 | Case report | Spondylodiscitis (1) | S. aureus (1) | Clinical cure (1) | 1000 + 1000 + 500 mg for 6 times (1) | >4 doses (1) |
Molina Collada J, et al. | [36] | 1 | Case report | Septic arthritis (1) | Other Gram-positive (1) | Clinical cure (1) | 1500 mg (1) | 1 dose (1) |
Bryson-Cagn C, et al. | [37] | 10 | Retrospective | Osteomyelitis (4) Septic arthritis (3) Spondylodiscitis (3) | S. aureus (10) | Clinical cure (6) Clinical failure (3) NA (1) | 1000 mg (5) 1500 + 1000 + 500 + 500 + 500 mg (1) 1000 + 500 mg (3) 1000 + 500 + 500 mg (1) | 1 dose (5) 2 doses, 1 week apart (3) 3 doses, 1 week apart (1) >4 doses (1) |
Type of osteoarticular infections | |
N. of patients included | 388 (86.2%) |
Osteomyelitis (n, %) | 280 (72.2%) |
Spondylodiscitis (n, %) | 79 (20.4%) |
Septic arthritis (n, %) | 29 (7.5%) |
Site of infection | |
N. of patients included | 178 (39.6%) |
Osteomyelitis (total) | 148 |
Lower extremities (n, %) | 123 (83.1%) |
Upper extremities (n, %) | 18 (12.1%) |
Other (n, %) | 7 (4.7%) |
Spondylodiscitis | 30 |
Lumbo-sacral (n, %) | 21 (70%) |
Cervical-thoracic (n, %) | 8 (26.7%) |
Both (n, %) | 1 (3.3%) |
Isolated pathogens | |
N. of isolated included | 243 |
S. aureus * (n, %) | 164 (67.5%) |
Other Gram-positive (n, %) | 24 (9.9%) |
CoNS ** (n, %) | 28 (11.5%) |
Enterococcus spp. *** (n, %) | 12 (4.9%) |
Streptococcus spp. (n, %) | 9 (3.7%) |
Gram-negative and fungi (n, %) | 6 (2.5%) |
Sample type | |
N. of patients included | 130 (28.9%) |
Bone biopsy or deep tissues (n, %) | 110 (84.6%) |
Blood (n, %) | 19 (14.6%) |
Bone biopsy or deep tissues and blood (n, %) | 1 (0.8%) |
Surgery before DBV | |
N. of patients included | 159 (35.3%) |
Patients who underwent surgery before DBV* (n,%) | 110 (69.2%) |
Patients who did not undergo surgery before DBV (n,%) | 49 (30.8%) |
Antibiotics pre-DBV | |
N. of patients included | 239 (53.1%) |
None (n,%) | 83 (34.7%) |
Unspecified molecule (n,%) | 64 (26.8%) |
Anti-MRSA IV (n,%) | 47 (19.7%) |
Anti-MRSA AND anti-Gram-negative po (n,%) | 16 (6.7%) |
Anti-MRSA AND anti-Gram-negative IV (n,%) | 14 (5.9%) |
Anti-MRSA po (n,%) | 8 (3.4%) |
Anti-Gram-positive (n,%) | 7 (2.9%) |
Reason to switch to DBV | |
N. of patients included | 96 (21.3%) |
Failure of the previous antimicrobial regimen (n,%) | 45 (46.9%) |
Simplification (n,%) | 19 (19.8%) |
Adverse reaction (n,%) | 14 (14.6%) |
Other (n,%) | 18 (18.8%) |
Adverse reactions to DBV | |
N. of patients included | 285 (63.3%) |
No adverse reactions (n,%) | 255 (89.5%) |
Adverse reaction (n,%): | 30 (10.5%) |
➢ Unspecified (n,%) | 13 (4.6%) |
➢ Cutaneous (n,%) | 7 (2.5%) |
➢ Nausea (n,%) | 6 (2.1%) |
➢ Diarrhoea (n,%) | 2 (0.7%) |
➢ INR abnormalities (n,%) | 1 (0.4%) |
➢ Acute kidney injuries (n,%) | 1 (0.4%) |
Antibiotics co-administered | |
N. of patients included | 238 (52.9%) |
None (n,%) | 182 (76.5%) |
Unspecified molecule (n,%) | 22 (9.2%) |
Anti-MRSA AND anti-Gram-negative IV (n,%) | 10 (4.2%) |
Anti-MRSA AND anti-Gram-negative po (n,%) | 13 (5.5%) |
Anti-MRSA po (n,%) | 11 (4.6%) |
DBV Scheme of Administration | n | 1500 + 1500 * n | 1500 + 1000 * n | 1500 + 500 * n | 1000 + 500 * n | 750 + 750 * n | Total (320 Patients) |
---|---|---|---|---|---|---|---|
1 dose | 0 | 26 | 6 | 0 | 32 (10.0%) | ||
2 doses, More than 1 week apart | 1 | 9 | 3 | 1 | 0 | 0 | 13 (4.1%) |
2 doses, 1 week apart | 1 | 177 | 0 | 2 | 5 *** | 0 | 184 (57.5%) |
3 doses, More than 1 week apart | 2 | 7 | 0 | 0 | 1 | 0 | 8 (2.5%) |
3 doses, 1 week apart | 2 | 3 | 0 | 0 | 4 | 0 | 7 (2.2%) |
4 doses, More than 1 week apart | 3 | 10 | 17 | 0 | 3 | 0 | 30 (9.4%) |
4 doses, 1 week apart | 3 | 0 | 0 | 1 * | 4 | 0 | 5 (1.6%) |
> 4 doses | x | 3 | 9 | 4 ** | 24 **** | 1 | 41 (12.8%) |
Outcome at last visit | ||
N. of patients included | 401 (89.1%) | |
Success (n,%) | 318 (79.3%) | |
Failure for persistent infection (n,%) | 44 (11.0%) | |
Failure for relapse (n,%) | 21 (5.2%) | |
Failure for need to switch therapy (n,%) | 10 (2.5%) | |
Lost-to-follow-up (n,%) | 5 (1.2%) | |
Infection-related death (n,%) | 1 (0.2%) | |
Unrelated death (n,%) | 2 (0.5%) | |
Outcome within and after 4 weeks since the end of treatment | ||
N. of patients included | 12; 274 (60.9%) | |
Outcome within 4 weeks | Outcome after 4 weeks | |
Success (n,%) | 231 (84.3%) | 212 (77.4%) |
Failure-persistent infection (n,%) | 37 (13.5%) | 25 (9.1%) |
Failure-relapse (n,%) | 2 (0.7%) | 20 (7.3%) |
Failure-switch therapy (n,%) | 0 (0.0%) | 10 (3.6%) |
Lost-to-follow-up (n,%) | 4 (1.5%) | 5 (1.8%) |
Infection-related death (n,%) | 0 (0.0%) | 0 (0.0%) |
Unrelated death (n,%) | 0 (0.0%) | 2 (0.7%) |
Favourable Outcome | Unfavourable Outcome | |
N. of patients included | 318 | 76 |
Surgery before DBV | ||
Patients with available data | 112 | 16 |
Subjected to surgery before DBV (n,%) | 90 (80.4%) | 4 (25%) |
Did not undergo surgery before DBV (n,%) | 22 (19.6%) | 12 (75%) |
Isolated pathogens | ||
Patients with available data | 68 | 10 |
MRSA (n,%) | 39 (57.4%) | 8 (80%) |
MSSA (n,%) | 14 (20.6%) | 2 (20%) |
Other Gram-positive (n,%) | 6 (8.8%) | 0 (0.0%) |
CoNS (n,%) | 6 (8.8%) | 0 (0.0%) |
Enterococcus spp. (n,%) | 2 (2.9%) | 0 (0.0%) |
Streptococcus spp. (n,%) | 1 (1.5%) | 0 (0.0%) |
Type of osteoarticular infections | ||
Patients with available data | 242 | 59 |
Osteomyelitis | 180 (74.4%) | 41 (70.7%) |
Spondylodiscitis | 45 (18.6%) | 14 (23.7%) |
Septic arthritis | 17 (7%) | 4 (6.8%) |
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Lovatti, S.; Tiecco, G.; Mulé, A.; Rossi, L.; Sforza, A.; Salvi, M.; Signorini, L.; Castelli, F.; Quiros-Roldan, E. Dalbavancin in Bone and Joint Infections: A Systematic Review. Pharmaceuticals 2023, 16, 1005. https://doi.org/10.3390/ph16071005
Lovatti S, Tiecco G, Mulé A, Rossi L, Sforza A, Salvi M, Signorini L, Castelli F, Quiros-Roldan E. Dalbavancin in Bone and Joint Infections: A Systematic Review. Pharmaceuticals. 2023; 16(7):1005. https://doi.org/10.3390/ph16071005
Chicago/Turabian StyleLovatti, Sofia, Giorgio Tiecco, Alice Mulé, Luca Rossi, Anita Sforza, Martina Salvi, Liana Signorini, Francesco Castelli, and Eugenia Quiros-Roldan. 2023. "Dalbavancin in Bone and Joint Infections: A Systematic Review" Pharmaceuticals 16, no. 7: 1005. https://doi.org/10.3390/ph16071005
APA StyleLovatti, S., Tiecco, G., Mulé, A., Rossi, L., Sforza, A., Salvi, M., Signorini, L., Castelli, F., & Quiros-Roldan, E. (2023). Dalbavancin in Bone and Joint Infections: A Systematic Review. Pharmaceuticals, 16(7), 1005. https://doi.org/10.3390/ph16071005