, albeit indicated for the treatment of skin structure infections, is used for a much wider range of infections. This drug is characterized by a long half-life (more than 200 hours), a favorable safety profile, and an activity against a wide array of gram-positive organisms, including several strains of Staphylococci and Enterococci.
In this study, we presented 3 cases of critically ill
patients treated with dalbavancin
. All patients were therapeutically monitored for plasma dalbavancin
concentrations; ultrafiltrate dalbavancin
concentrations were assessed in a patient undergoing continuous renal-replacement therapy. Dalbavancin
concentrations were measured using a validated liquid chromatographic method coupled with mass spectrometry.
All 3 severely ill patients experiencing necrotizing fasciitis
were successfully treated during the acute phase with dalbavancin
clearance in patient 3 (0.334 L/h) was considerably increased compared with values measured in the other 2 patients (0.054 and 0.075 L/h) and with data reported in the literature (0.04–0.06 L/h).
Our case reports presented preliminary evidence that dalbavancin
can be considered a therapeutic option for necrotizing fasciitis
in intensive care unit patients. The role of hypoalbuminemia during dalbavancin
exposure merits further investigation.