REAL-WORLD THERAPEUTIC DRUG MONITORING OF DALBAVANCIN FOLLOWING A DOSE REGIMEN OF 1,500 MG AT DAY 1, 15, AND 43

Aim To validate a day 1, 15, and 43 intravenous dalbavancin regimen for infections requiring 12 weeks of treatment by measuring dalbavancin serum concentrations. Method We conducted a bicentric study of patients who received three injections of dalbavancin at 1,500 mg to cover a 12-week treatment between January 2020 and May 2024. We collected patient's characteristics, microbiological data, and dalbavancin concentrations before reinjection on Days 15 and 43, and at 12 weeks. The target attainment of total dalbavancin concentration was 8.04 mg/L over time. Concentrations in patients with a body mass index greater than or lesser than 30 kg/m² and with albumin levels greater than or less than 30 g/L were compared. Results Forty-two patients with 39 bone and joint infections and three vascular infections were included. Dalbavancin serum concentrations were above 8.04 mg/L for 100% of the measurements (76/76), including patients with hypoalbuminemia or obesity, noting that non-significant lower concentrations were recorded in obese versus non-obese patients. Conclusions Our results suggest that dalbavancin 3-dose regimen (day 1,15, and 43) allows covering a three-month antibiotic treatment period. Drug monitoring for patients with hypoalbuminemia or obesity should be performed until larger studies confirm these findings.