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

TY - JOUR

T1 - Dalbavancin for outpatient parenteral antimicrobial therapy of skin and soft tissue infections in a returning traveller: Proposal for novel treatment indications

AU - Mischlinger, Johannes

AU - Lagler, Heimo

AU - Harrison, Nicole

AU - Ramharter, Michael

PY - 2017/9

Y1 - 2017/9

N2 - 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.

AB - 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.

KW - Abscess/drug therapy

KW - Adult

KW - Ambulatory Care

KW - Austria

KW - Cellulitis/drug therapy

KW - Dose-Response Relationship, Drug

KW - Drug Administration Schedule

KW - Emergency Service, Hospital

KW - Humans

KW - Infusions, Intravenous

KW - Male

KW - Methicillin-Resistant Staphylococcus aureus

KW - Soft Tissue Infections/diagnosis

KW - Staphylococcal Skin Infections/diagnosis

KW - Teicoplanin/analogs & derivatives

KW - Travel-Related Illness

KW - Tropical Climate

U2 - 10.1007/s00508-017-1243-6

DO - 10.1007/s00508-017-1243-6

M3 - SCORING: Journal article

C2 - 28776100

VL - 129

SP - 642

EP - 645

JO - WIEN KLIN WOCHENSCHR

JF - WIEN KLIN WOCHENSCHR

SN - 0043-5325

IS - 17-18

ER -