{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:30:36Z","timestamp":1773984636449,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Dalbavancin is a semisynthetic lipoglycopeptide, which possesses great potential for bactericidal activity similar to antimicrobials with the same mechanism of action, such as vancomycin and teicoplanin. Due to its very prolonged half-life, it can be used in a single or two-dose regimen to treat infections by Gram-positive microorganisms, even resistant ones, such as methicillin-resistant Staphylococcus aureus (MRSA). Currently, it is approved only for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). The aim of this study was to investigate the clinical and microbiological characteristics of patients to whom dalbavancin was administered at the University Hospital of Heraklion and evaluate its use in regard to the COVID-19 pandemic. In total, 146 patients were included in this retrospective cohort study evaluating the use of dalbavancin from the first time it was used in 2017 until the end of 2022. The median age was 68 years (range: 21\u201396 years), and 86 (59%) patients were male. The most common indications for dalbavancin use were osteoarticular infections in 43%, followed by ABSSSIs in 37%, and cardiovascular infections in 10%. Dalbavancin was used empirically in one out of three patients, most commonly with the indication of ABSSSIs, and most commonly in the post-COVID-19 era. The most frequently isolated pathogens were coagulase-negative staphylococci in 70%, S. aureus in 27%, Enterococcus spp. in 22%, and Streptococcus spp. in 8%, while one out of three infections were polymicrobial. In 12% of patients, the infection was not cured, but no patients died. For patients with ABSSSIs, endocarditis and vascular infections, and bacteremia, the cure rates were more than 90%, and in osteoarticular infections, the cure rate was 76%. Thus, dalbavancin has great potential for use in complicated and invasive infections that may require prolonged intravenous antimicrobial treatment. However, further studies are required to formally investigate its role in such infections.<\/jats:p>","DOI":"10.3390\/antibiotics12071205","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T21:20:14Z","timestamp":1689801614000},"page":"1205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Real-World Data Regarding Dalbavancin Use before and during the COVID-19 Pandemic\u2014A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-5674","authenticated-orcid":false,"given":"Petros","family":"Ioannou","sequence":"first","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-6453","authenticated-orcid":false,"given":"Nora","family":"Wolff","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Mathioudaki","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Spanias","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6981-8535","authenticated-orcid":false,"given":"Nikolaos","family":"Spernovasilis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"German Oncology Center, Limassol 4108, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0255-5926","authenticated-orcid":false,"given":"Diamantis P.","family":"Kofteridis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1021\/acsinfecdis.7b00258","article-title":"Developments in Glycopeptide Antibiotics","volume":"4","author":"Blaskovich","year":"2018","journal-title":"ACS Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.37201\/req\/s01.07.2021","article-title":"Dalbavancin","volume":"34","year":"2021","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/QCO.0000000000000430","article-title":"The role of dalbavancin in skin and soft tissue infections","volume":"31","author":"Bassetti","year":"2018","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1111\/jcpt.13719","article-title":"Global trends of dalbavancin: A bibliometric analysis","volume":"47","author":"Ikuta","year":"2022","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1093\/jac\/dkz162","article-title":"On- and off-label utilization of dalbavancin and oritavancin for Gram-positive infections","volume":"74","author":"Morrisette","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106107","DOI":"10.1016\/j.ijantimicag.2020.106107","article-title":"Current trends in the real-life use of dalbavancin: Report of a study panel","volume":"56","author":"Gambardella","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1086\/427283","article-title":"Efficacy and safety of weekly dalbavancin therapy for catheter-related bloodstream infection caused by gram-positive pathogens","volume":"40","author":"Raad","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s40264-015-0374-9","article-title":"Safety of Dalbavancin in the Treatment of Skin and Skin Structure Infections: A Pooled Analysis of Randomized, Comparative Studies","volume":"39","author":"Dunne","year":"2016","journal-title":"Drug Saf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e02280-18","DOI":"10.1128\/AAC.02280-18","article-title":"Safety and Efficacy of Prolonged Use of Dalbavancin in Bone and Joint Infections","volume":"63","author":"Morata","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"223","DOI":"10.2147\/TCRM.S271445","article-title":"Review: A Safety Profile of Dalbavancin for On- and Off-Label Utilization","volume":"17","author":"Simonetti","year":"2021","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106210","DOI":"10.1016\/j.ijantimicag.2020.106210","article-title":"Comparison of dalbavancin to standard-of-care for outpatient treatment of invasive Gram-positive infections","volume":"56","author":"Veve","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ijantimicag.2017.11.008","article-title":"Dalbavancin in the treatment of different gram-positive infections: A real-life experience","volume":"51","author":"Bouza","year":"2018","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e0238522","DOI":"10.1128\/spectrum.02385-22","article-title":"Evaluation of Dalbavancin Use on Clinical Outcomes, Cost-Savings, and Adherence at a Large Safety Net Hospital","volume":"11","author":"Lueking","year":"2023","journal-title":"Microbiol. Spectr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s40121-019-0247-0","article-title":"Dalbavancin Use in Vulnerable Patients Receiving Outpatient Parenteral Antibiotic Therapy for Invasive Gram-Positive Infections","volume":"8","author":"Bork","year":"2019","journal-title":"Infect. Dis. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"ofz028","DOI":"10.1093\/ofid\/ofz028","article-title":"Dalbavancin as Secondary Therapy for Serious Staphylococcus aureus Infections in a Vulnerable Patient Population","volume":"6","author":"Beieler","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s10096-022-04427-2","article-title":"GRIC Dalbavancin in clinical practice: A particular place for the elderly?","volume":"41","author":"Wackenheim","year":"2022","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/QCO.0000000000000714","article-title":"Role or oritavancin and dalbavancin in acute bacterial skin and skin structure infections and other potential indications","volume":"34","author":"Bassetti","year":"2021","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s15010-019-01354-x","article-title":"Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection","volume":"47","author":"Tobudic","year":"2019","journal-title":"Infection"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1128\/AAC.04550-14","article-title":"Extended-duration dosing and distribution of dalbavancin into bone and articular tissue","volume":"59","author":"Dunne","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1080\/14787210.2022.2060820","article-title":"Role of dalbavancin as combination therapy: Evidence from the literature and clinical scenarios","volume":"20","author":"Cacopardo","year":"2022","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"266","DOI":"10.3390\/idr14020032","article-title":"Evaluating the Use of Dalbavancin for Off-Label Indications","volume":"14","author":"Taylor","year":"2022","journal-title":"Infect. Dis. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3349","DOI":"10.2147\/DDDT.S313756","article-title":"Real-World Use of Dalbavancin in the Era of Empowerment of Outpatient Antimicrobial Treatment: A Careful Appraisal Beyond Approved Indications Focusing on Unmet Clinical Needs","volume":"15","author":"Gatti","year":"2021","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_23","first-page":"1222","article-title":"The current and future off-label uses of dalbavancin: A narrative review","volume":"27","author":"Fiore","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mazzitelli, M., Gatti, M., Scaglione, V., Mengato, D., Trevenzoli, M., Sattin, A., Pea, F., and Cattelan, A.M. (2022). Off-Label Use of Dalbavancin for Sequential Treatment of Spondylodiscitis by Methicillin-Resistant Staphylococcus aureus: A Retrospective Single-Centre Experience. Antibiotics, 11.","DOI":"10.3390\/antibiotics11101377"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12941-019-0329-6","article-title":"DALBACEN cohort: Dalbavancin as consolidation therapy in patients with endocarditis and\/or bloodstream infection produced by gram-positive cocci","volume":"18","author":"Vinuesa","year":"2019","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1093\/jac\/dkaa188","article-title":"Dalbavancin for the management of osteomyelitis: A major step forward?","volume":"75","author":"Almangour","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ijid.2019.02.013","article-title":"Multicenter clinical experience of real life Dalbavancin use in gram-positive infections","volume":"81","author":"Wunsch","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"ofy331","DOI":"10.1093\/ofid\/ofy331","article-title":"Dalbavancin for the Treatment of Osteomyelitis in Adult Patients: A Randomized Clinical Trial of Efficacy and Safety","volume":"6","author":"Rappo","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.diagmicrobio.2018.10.007","article-title":"Dalbavancin for the management of gram-positive osteomyelitis: Effectiveness and potential utility","volume":"93","author":"Almangour","year":"2019","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1093\/jac\/dkac178","article-title":"Dalbavancin in Gram-positive periprosthetic joint infections","volume":"77","author":"Simon","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Buz\u00f3n-Mart\u00edn, L., Zollner-Schwetz, I., Tobudic, S., Cercenado, E., and Lora-Tamayo, J. (2021). Dalbavancin for the Treatment of Prosthetic Joint Infections: A Narrative Review. Antibiotics, 10.","DOI":"10.3390\/antibiotics10060656"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jgar.2021.03.026","article-title":"Dalbavancin treatment for prosthetic joint infections in real-life: A national cohort study and literature review","volume":"25","author":"Matt","year":"2021","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Durante-Mangoni, E., Riccardi, A., Guarino, M., Cesaro, F., Lugar\u00e0, M., Mascolo, S., Morelli, L., Natale, V., and Andreoni, M. (2022). Emergency department care of ABSSSI with dalbavancin infusion, direct discharge, and outpatient telemedicine follow up: A study protocol. J. Chemother., 1\u20137.","DOI":"10.1080\/1120009X.2022.2134616"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1080\/14787210.2021.1894130","article-title":"The role of dalbavancin for Gram positive infections in the COVID-19 era: State of the art and future perspectives","volume":"19","author":"Andreoni","year":"2021","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"sti41\/1588","DOI":"10.52198\/22.STI.41.WH1588","article-title":"Dalbavancin During the COVID-19 Pandemic","volume":"41","author":"Caputo","year":"2022","journal-title":"Surg. Technol. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41422-020-00450-0","article-title":"Dalbavancin binds ACE2 to block its interaction with SARS-CoV-2 spike protein and is effective in inhibiting SARS-CoV-2 infection in animal models","volume":"31","author":"Wang","year":"2021","journal-title":"Cell Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"ofaa293","DOI":"10.1093\/ofid\/ofaa293","article-title":"Use of a Standardized Dalbavancin Approach to Facilitate Earlier Hospital Discharge for Vulnerable Patients Receiving Prolonged Inpatient Antibiotic Therapy","volume":"7","author":"Shihadeh","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"106746","DOI":"10.1016\/j.ijantimicag.2023.106746","article-title":"REDS study: Retrospective effectiveness study of dalbavancin and other standard of care of the same IV antibiotic class in patients with ABSSSI","volume":"61","author":"Papavramidis","year":"2023","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s40261-021-01028-3","article-title":"Dalbavancin Efficacy and Impact on Hospital Length-of-Stay and Treatment Costs in Different Gram-Positive Bacterial Infections","volume":"41","author":"Poliseno","year":"2021","journal-title":"Clin. Drug Investig."},{"key":"ref_40","unstructured":"(2023, June 13). Dalvance FDA Approval History. Available online: https:\/\/www.drugs.com\/history\/dalvance.html."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1080\/14787210.2021.1828865","article-title":"Acute Bacterial Skin and Skin-Structure Infections, efficacy of Dalbavancin: A systematic review and meta-analysis","volume":"20","author":"Nava","year":"2022","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"106069","DOI":"10.1016\/j.ijantimicag.2020.106069","article-title":"Treatment of osteoarticular, cardiovascular, intravascular-catheter-related and other complicated infections with dalbavancin and oritavancin: A systematic review","volume":"56","author":"Thomas","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_43","first-page":"532","article-title":"Dalbavancin for treating prosthetic joint infections caused by Gram-positive bacteria: A proposal for a low dose strategy. A retrospective cohort study","volume":"32","year":"2019","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.ijantimicag.2019.08.006","article-title":"French national cohort of first use of dalbavancin: A high proportion of off-label use","volume":"54","author":"Dinh","year":"2019","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1093\/cid\/ciy279","article-title":"Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna","volume":"67","author":"Tobudic","year":"2018","journal-title":"Clin. Infect. Dis."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/7\/1205\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:15:10Z","timestamp":1760127310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/7\/1205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,19]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["antibiotics12071205"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics12071205","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,19]]}}}