ArticleBMC research notes2026
Real world use of dalbavancin for bone and joint infections: a retrospective case series in adults and children.
Article in BMC research notes, 2026. 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
backgroundBone and joint infections (BJIs) often require prolonged parenteral therapy, with challenges of hospitalization and vascular access [1–4]. Dalbavancin, a long-acting lipoglycopeptide, enables once-weekly dosing [7–10]. This study reports real-world outcomes of dalbavancin, used off-label in adults and children with BJIs.
methodsWe conducted a retrospective, single-centre case series of 14 consecutive patients (10 adults, 4 paediatric) with Gram-positive BJIs treated between January 2024 and April 2025. All received ≥ 3 weekly dalbavancin doses (definitive therapy), with oral step-down to complete a total treatment course of 8–12 weeks. Demographics, microbiology, therapy and outcomes were assessed with ≥ 6 months follow-up. MICs were tested using E-test strips; results interpreted using CLSI 2021 breakpoints [12]. Off-label nature of therapy was noted.
resultsMedian age was 36 years (range 5–80), including 4 paediatric patients. MRSA accounted for 57% of the isolates. Dalbavancin MICs were consistently low (≤ 0.064 mg/L) [12, 14]. Median prior antibiotic exposure was 10 days before switch over to dalbavancin. All patients achieved end-of-therapy cure defined as the resolution of signs and symptoms of infection with no requirement for additional antibiotics for the primary infection and no recurrence. At 6 months, 92.9% patients remained infection-free while one patient who was still under follow up, showed sustained clinical improvement. Therapy was well tolerated with only two mild, self-limiting adverse events but all paediatric patients tolerated therapy well with no adverse events.
conclusionDalbavancin, used off-label, demonstrated high level of efficacy, tolerability and outpatient feasibility in this small consecutive cohort, supporting its potential role as a treatment option for complex BJIs, including paediatric and bacteraemia-associated cases. Its pharmacokinetics enable streamlined therapy and reduced healthcare utilisation, supporting its role as a valuable therapeutic option for outpatient parenteral therapy [17-19, 21].
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