{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:27:40Z","timestamp":1785374860288,"version":"3.55.0"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this study was to evaluate the real-world efficacy, safety, and financial impact of off-label dalbavancin use. (2) Methods: This is a retrospective, observational study conducted within a 4-hospital health system. Adult patients who received dalbavancin from January 2018 to January 2021 for an off-label indication were included. The primary outcome was clinical success at 90 days. Secondary outcomes included safety (nephrotoxicity and hepatotoxicity). A pharmacoeconomic analysis was performed by comparing the cost of dalbavancin to the anticipated cost of patient stay if standard IV therapy was given. (3) Results: Forty-eight patients met study criteria. Indications included osteomyelitis (54%), endocarditis (23%), bacteremia (15%), and prosthetic joint infection (8%). The predominant organism was S. aureus (60%), with 42% caused by methicillin-resistant S. aureus. Overall, 41 (85%) patients achieved clinical success at 90 days, including 85% with osteomyelitis, 82% with endocarditis, and 86% with bacteremia. There were no instances of nephrotoxicity or hepatotoxicity. Estimated cost avoidance per patient was USD 5313 and USD 1683 if traditional IV therapy would have been completed in the hospital and skilled nursing facility, respectively. (4) Conclusion: Dalbavancin was associated with a relatively high success rate for the treatment of off-label indications and may be a cost-effective alternative to traditional IV antibiotic therapy.<\/jats:p>","DOI":"10.3390\/idr14020032","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:23:11Z","timestamp":1649722991000},"page":"266-272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Evaluating the Use of Dalbavancin for Off-Label Indications"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4819-5508","authenticated-orcid":false,"given":"Katherine","family":"Taylor","sequence":"first","affiliation":[{"name":"Wake Forest Baptist Health Department of Pharmacy, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Williamson","sequence":"additional","affiliation":[{"name":"Wake Forest Baptist Health Department of Pharmacy, Winston-Salem, NC 27157, USA"},{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Luther","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Stone","sequence":"additional","affiliation":[{"name":"Wake Forest Baptist Health Department of Pharmacy, Winston-Salem, NC 27157, USA"},{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Johnson","sequence":"additional","affiliation":[{"name":"Wake Forest Baptist Health Department of Pharmacy, Winston-Salem, NC 27157, USA"},{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-0331","authenticated-orcid":false,"given":"Zachary","family":"Gruss","sequence":"additional","affiliation":[{"name":"ProMedica Toledo Hospital Department of Pharmacy, Toledo, OH 43606, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Russ-Friedman","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Ohl","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3900-8758","authenticated-orcid":false,"given":"James","family":"Beardsley","sequence":"additional","affiliation":[{"name":"Wake Forest Baptist Health Department of Pharmacy, Winston-Salem, NC 27157, USA"},{"name":"Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"ref_1","first-page":"2","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_2","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_3","first-page":"9","article-title":"Left Ventricular Assist Device Infections and the Potential Role for Dalbavancin: A Case Report","volume":"6","author":"Pouch","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_4","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_5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/ofid\/ofz274","article-title":"Long-Acting Lipoglycopeptides: \u2018Lineless Antibiotics\u2019 for Serious Infections in Persons Who Use Drugs","volume":"6","author":"Morrisette","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_6","first-page":"1","article-title":"Dalbavancin for the Treatment of Osteomyelitis in Adult Patients: A Randomized Clinical Trial of Efficacy and Safety","volume":"6","author":"Rappo","year":"2018","journal-title":"Open Forum Infect. Dis."},{"key":"ref_7","unstructured":"(2021, October 10). Hospital Adjusted Expenses per Inpatient Day. Available online: http:\/\/kff.org\/other\/state-indicator\/expenses-per-inpatient-day."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1056\/NEJMoa053783","article-title":"aureus Endocarditis and Bacteremia Study Group. Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus","volume":"355","author":"Fowler","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_9","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_10","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_11","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_12","first-page":"Doc03","article-title":"Potential savings through single-dose intravenous Dalbavancin in long-term MRSA infection treatment\u2014A health economic analysis using German DRG data","volume":"7","author":"Wilke","year":"2019","journal-title":"GMS Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11908-021-00764-z","article-title":"The Use of Long-Acting Lipoglycopeptides for the Treatment of Serious, Off-label Infections: A Review of the Literature","volume":"23","author":"Gruss","year":"2021","journal-title":"Curr. Infect. Dis Rep."}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/14\/2\/32\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:51:28Z","timestamp":1760136688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/14\/2\/32"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,11]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["idr14020032"],"URL":"https:\/\/doi.org\/10.3390\/idr14020032","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,11]]}}}