YouTube video by 戦国・小和田チャンネル

YouTube video by GamingSuperHero

The burden of bacterial infections, including skin and soft-tissue infections (SSTI) and bone and joint infections (BJI), is substantial. We aimed to assess clinical outcomes in non-severe cases of SSTI and BJI following dalbavancin treatment compared with those after other standard treatments.MethodsThis retrospective observational study used the multicentre TriNetX electronic medical records database. Following propensity score matching (PSM), ORs with 95% CIs were estimated to compare hospitalization risk following dalbavancin administration relative to other antimicrobialsResultsBefore PSM, 957 and 73 853 participants were identified in the dalbavancin and other standard treatment groups, respectively. After PSM, 957 patients remained in each cohort, with hospitalization observed in 167 (17.5%) and 239 (25.0%) participants in the dalbavancin and other standard treatment groups, respectively (OR 0.64 [95% CI 0.51–0.79]; P < 0.001). The ORs for hospitalization were 0.67 [0.54–0.84]; P < 0.001 and 0.60 [0.48–0.75]; P < 0.001 by comparing with for methicillin-resistant staphylococcus aureus (MRSA) covering antimicrobials and MRSA non-covering antimicrobials in the standard treatment group, respectively.ConclusionsDalbavancin treatment was associated with significantly fewer hospitalizations than standard therapy in non-severe cases of SSTI and BJI. The results should be interpreted cautiously due to selection bias and potential unmeasured confounders.

YouTube video by Fitness TM

Virtual nature for mental health of people in Ukraine

YouTube video by Cringyroll

Dalbavancin is increasingly used off-label for chronic Gram-positive bone and joint infections (BJIs) requiring prolonged antimicrobial therapy, but optimal dosing strategies and the role of therapeutic drug monitoring (TDM) remain unclear. We evaluated the real-world implementation of a proactive TDM-guided dalbavancin workflow within an outpatient parenteral antimicrobial therapy (OPAT) programme.MethodsSingle-centre prospective observational implementation study including adult patients with BJIs consecutively treated with dalbavancin in OPAT service between July 2022 and August 2025. A multidisciplinary team developed a workflow incorporating TDM-guided pharmacokinetic modelling to individualize dosing intervals after fixed initial administrations (Days 1, 8 and 43). Target Cmin concentrations were ≥8 mg/L, later increased to ≥15 mg/L after European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoint revision. Primary outcomes included implementation metrics (feasibility, fidelity and appropriateness). Secondary outcomes were clinical effectiveness, safety and overall workflow success.ResultsThe workflow was applied to 101 patients accounting for 418 TDM-guided dalbavancin administrations (feasibility). Three patient-driven treatment discontinuations were observed (3/101, 3.0%), and scheduled administrations occurred within the predefined time window in 335/418 (83.5%) of cases (fidelity). Pharmacological target attainment was achieved in 285/342 (89.6%) of administrations without dosing delays (appropriateness). Clinical effectiveness was achieved in 55/73 (75.3%) patients completing therapy, with 28/101 (28%) still on treatment. Adverse events–related discontinuation occurred in 3/101 (3%) patients. Overall workflow success was observed in 74/101 (73.2%) patients.ConclusionsA multidisciplinary TDM-guided dalbavancin workflow within an OPAT programme was feasible and safe, achieving high target attainment and favourable clinical outcomes. This approach supports individualized long-acting dalbavancin therapy for complex chronic BJIs.

YouTube video by Wolfgang Petry - Topic