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Dalbavancin as a second-line treatment in methicillin-resistant Staphylococcus aureus prosthetic vascular graft infection

  • Arturo CicculloEmail author
  • Gabriele Giuliano
  • Francesco Vladimiro Segala
  • Eleonora Taddei
  • Damiano Farinacci
  • Federico Pallavicini

Dear Sir,

We read with interest the work by Tobudic et al. [1] on the on- and off-label use of long-acting lipoglycopeptide (laLGP) dalbavancin, which highlights the effectiveness and safety of this new antibiotic used in a cohort of 46 patients with both skin and soft tissue infections and commonly encountered deep-seated, often severe, infections. These results certainly look very promising and could lead to an expansion of the use limits of dalbavancin; both the approved laLGPs, i.e., oritavancin and dalbavancin, are currently approved only for the treatment of adults with acute bacterial skin and skin structure infections (ABSSSIs) caused by susceptible Gram-positive germs. However, some clinical-practice experiences [2, 3] and a recent clinical trial [4] demonstrated the efficacy of dalbavancin also for the treatment of deep-seated infections that usually require prolonged intravenous antibiotic therapy, thus resulting not only in an advantage in tolerability but also in...



This study was performed as part of our routine work.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest to report.


  1. 1.
    Tobudic S, Forstner C, Burgmann H, et al. Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection. Infection 2019;47:1013–20. Scholar
  2. 2.
    Bork JT, Heil EL, Berry S, et al. Dalbavancin use in vulnerable patients receiving outpatient parenteral antibiotic therapy for invasive gram-positive infections. Infect Dis Ther. 2019;8:171–84.CrossRefGoogle Scholar
  3. 3.
    Bouza E, Valerio M, Soriano A, et al. Dalbavancin in the treatment of different gram-positive infections: a real-life experience. Int J Antimicrob Agents. 2018;51:571–7. Scholar
  4. 4.
    Rappo U, Puttagunta S, Shevchenko V, et al. Dalbavancin for the treatment of osteomyelitis in adult patients: a randomized clinical trial of efficacy and safety. Open Forum Infect Dis. 2018;6:ofy331. Scholar
  5. 5.
    Knafl D, Tobudic S, Cheng SC, et al. Dalbavancin reduces biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE). Eur J Clin Microbiol Infect Dis. 2017;36:677–80. Scholar

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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Clinical Infectious DiseasesCatholic University of the Sacred HeartRomeItaly
  2. 2.Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Malattie InfettiveRomeItaly

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