ArticleTherapeutic drug monitoring2025
Therapeutic Drug Monitoring Versus Fixed-Interval Dosing of Dalbavancin in Implant-Associated Spinal Infections: Grand Round/A Case Study.
Article in Therapeutic drug monitoring, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundImplant-associated spinal infections (IASI) pose challenges for outpatient management due to the need for frequent intravenous antibiotic administration. Dalbavancin has a prolonged half-life and is a practical alternative.
methodsTwo cases of IASI were treated with dalbavancin in an outpatient setting over 10-12 weeks. One patient received therapeutic drug monitoring (TDM)-guided dosing, while the other was managed with fixed-interval dosing. Dalbavancin plasma concentrations were measured using liquid chromatography-tandem mass spectrometry, and dosing adjustments were guided by pharmacokinetic modeling.
resultsIn the TDM-guided case, three dalbavancin doses were sufficient to maintain therapeutic plasma concentrations (≥8 mg/L), whereas the fixed-interval approach required four doses. Both patients successfully completed therapy without recurrence of the infection during follow-up.
conclusionsTDM-guided dalbavancin therapy optimized drug exposure and reduced the number of doses compared with fixed-interval dosing, highlighting its potential to optimize treatment. Further research is required to establish standardized therapeutic drug monitoring protocols for the management of IASI.
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