Trough levels of dalbavancin during long-term treatment of prosthetic joint infections.

IF 2.3
Infectious diseases (London, England) Pub Date : 2025-10-01 Epub Date: 2025-05-04 DOI:10.1080/23744235.2025.2499144
Bo Söderquist, Max Möller, Samira Salihovic
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Abstract

Introduction: Dalbavancin is a lipoglycopeptide with an exceptionally long half-life that allows simplified administration, which may be of value in long-term treatment of bone and joint infections, such as prosthetic joint infections (PJIs). The objective was to determine trough (Cmin) values of dalbavancin during long-term PJI treatment according to the recommendation of the Swedish National Guidelines for Bone and Joint Infections: a loading dose of 1,500 mg on day 1 and another 1,500 mg on days 8-14, followed by day 28 administration of 1,000 mg every two weeks or 500 mg per week.

Patients/methods: Twelve patients with PJI treated with at least six doses of dalbavancin were prospectively followed up, serum samples were collected, and renal function was investigated. Dalbavancin concentrations were measured using ultra-high pressure liquid chromatography coupled with unispray tandem mass spectrometry (UHPLC-MS/MS).

Results: The median serum concentration (Cmin) 14 days after the first 1,500 mg dose was 36.3 mg/L (range: 6.6-62.4 mg/L). The median trough value at the date of the last given dose (1,000 mg) after a total of 6-7 doses was 53.6 mg/L (range: 32.0-97.5 mg/L). Three patients showed a tendency towards successive accumulation of dalbavancin during treatment. None of the patients showed any significant impairment in renal function.

Conclusions: Therapeutic drug monitoring during long-term dalbavancin treatment is recommended to avoid the risk of accumulation and unnecessarily high trough levels. In many cases, such monitoring can allow the dosing interval to be extended.

长期治疗假体关节感染期间达尔巴伐辛的低谷水平。
Dalbavancin是一种脂糖肽,半衰期特别长,可以简化给药,在骨和关节感染(如假体关节感染(PJIs))的长期治疗中可能有价值。目的是根据瑞典国家骨和关节感染指南的建议,确定长期PJI治疗期间达巴文星的槽(Cmin)值:第1天的负荷剂量为1,500 mg,第8-14天的负荷剂量为1,500 mg,随后第28天每两周给药1,000 mg或每周给药500 mg。患者/方法:对12例PJI患者进行至少6次达尔巴文星治疗的前瞻性随访,采集血清样本,并进行肾功能调查。采用超高压液相色谱-串联质谱法(UHPLC-MS/MS)测定Dalbavancin的浓度。结果:第一次1500mg给药后14天血清中位浓度(Cmin)为36.3 mg/L(范围:6.6 ~ 62.4 mg/L)。在总共6-7次给药后,最后一次给药(1,000 mg)日的中位谷值为53.6 mg/L(范围:32.0-97.5 mg/L)。3例患者在治疗过程中表现出达尔巴万辛连续积累的趋势。所有患者均未出现明显的肾功能损害。结论:建议在长期达巴文星治疗期间监测治疗药物,以避免积累风险和不必要的高低谷水平。在许多情况下,这种监测可以延长给药间隔。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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