{
  "abstract": "Background and Importance Dalbavancin is approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). However, its prolonged half-life and activity against Gram-positive pathogens have led to growing off-label use in complex infections. There is limited real-world data describing such use, particularly in secondary-level hospitals. Understanding these practices may support optimised antimicrobial stewardship and resource use.Aim and Objectives The primary objective was to describe off-label indications for dalbavancin and identify isolated microorganisms in patients treated at a secondary-level hospital. The secondary objective was to analyse patient characteristics and assess correlations between clinical variables and infection persistence or 90-day mortality.Material and Methods A retrospective, observational study was conducted including all patients who received dalbavancin between January 2017 and January 2025. Data were collected on demographics, clinical indication, prescribing department, microbiological findings, and treatment modality. Off-label use was defined as any indication other than ABSSSI. A stepwise backward selection linear regression model was used to evaluate associations with infection persistence or 90-day mortality. Analyses were performed using STATA 17.Results Thirty-seven patients were included; 97.3% (n=36) received dalbavancin off-label. The most frequent indications were prosthetic joint infection (29.7%), endocarditis and bacteraemia (16.2% each), spondylodiscitis (13.5%), and osteomyelitis (10.8%). Ambulatory consolidation therapy was used in 83.8% (n=31) following inpatient stabilisation. Gram-positive cocci were most frequently isolated: MRSA (24.3%), S. epidermidis (18.9%), E. faecalis (13.5%), MSSA (8.1%), and E. faecium (5.4%). Polymicrobial infections occurred in 24.3%. In regression analysis, only age remained in the final model (p=0.075), suggesting a trend toward persistent infection in older patients. The overall model was significant (p=0.0293).Conclusion and Relevance Dalbavancin was predominantly used off-label, especially for osteoarticular and prosthetic infections. Its pharmacokinetics enabled outpatient management of severe infections, supporting continuity of care and hospital resource optimisation. Age showed a non-significant trend toward infection persistence. Despite a limited sample size, these findings highlight dalbavancin’s utility in complex infections and reinforce the role of hospital pharmacists in promoting its rational, personalised use. References and/or Acknowledgements The authors wish to acknowledge the invaluable collaboration of the Hospital Pharmacy Department and the participating clinical services, whose support in data collection and patient management was instrumental to the completion of this study.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "P Vega González"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "D García Martínez"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "N Garrido Peño"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "M Andrino Rodríguez"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "L Fernández Valencia"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "A González Fuentes"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "M Carrera Sánchez"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "M Mañes Sevilla"
    },
    {
      "affiliations": [
        "Hospital Universitario De Móstoles, Servicio De Farmacia Hospitalaria, Madrid, Spain"
      ],
      "name": "M Segura Bedmar"
    }
  ],
  "title": "4CPS-124 Off-label use of dalbavancin in real-world clinical practice: a retrospective observational study",
  "uid": "17548ce0-b8f3-5294-ba8e-7ebfa423acff"
}