Dalbavancin for outpatient parenteral antimicrobial therapy of skin and soft tissue infections in a returning traveller : Proposal for novel treatment indications

Wien Klin Wochenschr. 2017 Sep;129(17-18):642-645. doi: 10.1007/s00508-017-1243-6. Epub 2017 Aug 3.

Abstract

Skin and soft tissue infections (SSTIs) are among the most common health problems in travellers returning from tropical and subtropical countries. Importantly, the prevalence of Staphylococcus aureus, the most common pathogen for purulent SSTIs, with specific drug resistance, such as methicillin resistant Staphylococcus aureus (MRSA) and those expressing virulence genes, such as Panton-Valentine-leukocidin is higher in tropical regions than in most high resource settings. This poses challenges for the empirical antimicrobial treatment of SSTIs in returning travellers. This short report describes a patient with a recent travel history to Hong Kong, Singapore and the Philippines who presented with multiple mosquito bites on both upper extremities and secondary bacterial superinfection. He had previously been prescribed oral beta-lactam antimicrobial therapy but lacked adherence to this treatment. Based on the risk for MRSA infection and problems with treatment adherence to oral therapy an outpatient parenteral antimicrobial therapy with dalbavancin was administered on days 0 and 7. Microbiological culture confirmed presence of MRSA and clinical follow-up demonstrated complete remission of the SSTI within 2 weeks. Dalbavancin is a promising treatment option for empirical parenteral treatment of SSTIs in returning travellers, a population at high risk for beta-lactam resistant S. aureus skin infections.

Keywords: Dalbavancin; MRSA; SSTI; Staphylococcus aureus; Travel medicine.

Publication types

  • Case Reports

MeSH terms

  • Abscess / drug therapy*
  • Adult
  • Ambulatory Care
  • Austria
  • Cellulitis / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Emergency Service, Hospital
  • Humans
  • Infusions, Intravenous
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / drug therapy*
  • Staphylococcal Skin Infections / diagnosis
  • Staphylococcal Skin Infections / drug therapy*
  • Teicoplanin / analogs & derivatives*
  • Teicoplanin / therapeutic use
  • Travel-Related Illness*
  • Tropical Climate

Substances

  • Teicoplanin
  • dalbavancin