4CPS-224 Experience of using dalbavancin in osteoarticular prosthetic infection

<h3>Background and Importance</h3> The treatment of prosthetic osteoarticular infection involves an appropriate surgical approach and the administration of intravenous (IV) antibiotics for a prolonged period. In different published studies, the use of dalbavancin has been evaluated as a valid alternative in the treatment of this infections using different dosing regimens. This initiative may help reduce hospital stay days, consequently lowering healthcare costs. <h3>Aim and Objectives</h3> Assess the use of dalbavancin at hospital discharge in patients with hip or knee prosthesis infection in a tertiary care hospital. <h3>Material and Methods</h3> Cross-sectional observational study of patients admitted for knee or hip prosthesis infection subjected to surgical cleaning and debridement with prosthesis retention (DAIR) or first-stage prosthetic replacement surgery discharged between January and June 2024 with dalbavancin. Evaluated: age, sex, type of infection, duration of inpatient treatment after surgery, hospital stay, results of microbiological cultures, dosage of dalbavancin used and economic cost. <h3>Results</h3> Dalbavancin was indicated in 16 patients, 10 in DAIR and six in first-stage prosthetic replacement surgery. Women: 68.8%, mean age: 69.88 ± 12.5ED years; knee prosthesis infection: 56.3%. Chronic infection: 50.00%. The median duration of inpatient treatment after surgery was 14 days (range: 10–22). The median length of hospital stay was 20 days (range: 10–53). Negative cultures were obtained in 25.0%, with S. epidermidis being the most frequent microorganism (43.75%). A regimen of 1,500 mg (day 1, day 8, and day 42) was used in 31.25%; 1,500 mg (day 1 and day 8): 31.25% and 1,500 mg followed by 1,000 mg every 2 weeks (8 to 12 weeks) in 37.5%. The economic cost of treatment per patient ranged between €2674.74 and €5349.48. The economic cost of avoided hospital days per patient is calculated between €12,600 and €16,800 for a minimum of 6 weeks of intravenous treatment. The calculated savings for the total number of patients based on the duration of inpatient treatment ranged from €210600 to €268800. <h3>Conclusion and Relevance</h3> The use of dalbavancin in these unapproved indications may help reduce days of hospital stay by reducing healthcare costs. Its use should be protocolised and its dosage should be individualised according to the days of IV treatment planned and those received in hospital after surgery and culture results. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest