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The following is a summary of “Trough levels of dalbavancin during long-term treatment of prosthetic joint infections,” published in the May 2025 issue of Infectious Diseases by Söderquist et al. 

Dalbavancin, a lipoglycopeptide with a notably long half-life, presents a promising potential for simplified administration, offering hope for the long-term treatment of bone and joint infections like prosthetic joint infections (PJIs).  

Researchers conducted a retrospective study to determine dalbavancin’s trough (C_min) values during long-term PJI treatment, following the Swedish National Guidelines for Bone and Joint Infections.  

They assessed 12 patients with PJI who received at least 6 doses of dalbavancin. Serum samples were collected, and renal function was assessed. Dalbavancin concentrations were measured using ultra-high pressure liquid chromatography coupled with unispray tandem mass spectrometry (UHPLC-MS/MS).  

The results showed that the median serum concentration (C_min) 14 days after the first 1,500 mg dose was 36.3 mg/L (range: 6.6–62.4 mg/L). The median trough value after the last 1,000 mg dose, following 6–7 doses, was 53.6 mg/L (range: 32.0–97.5 mg/L) and 3 patients exhibited a tendency toward successive accumulation of dalbavancin during treatment. No patients demonstrated significant impairment in renal function.  

Investigators concluded that therapeutic drug monitoring was advisable during prolonged dalbavancin therapy to mitigate the potential for drug accumulation and excessively high trough concentrations, often enabling the extension of the dosing interval. 

Source: tandfonline.com/doi/full/10.1080/23744235.2025.2499144