Table 1.
Characteristic | Patient | |||||||
---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
Age at DAL initiation, y/sex | 51/M | 31/F | 40/M | 37/F | 57/M | 64/F | 52/M | 57/M |
Weight, kg | 156 | 128 | 119 | 62 | 76 | 86 | 94 | 103 |
CrCl at DAL initiation, mL/min | 57.1 | 58.9 | 18 | 90 | 63 | 32 | 71 | 116 |
Type of LVAD at time of DAL initiation | Heartmate III | Heartmate III | Heartmate III | Heartware | Heartmate III | Heartmate II | Heartmate II | Heartmate III |
Reason for LVAD implantation | NICM | PPCM | NICM | PPCM | NICM | ICM | ICM | NICM |
LVAD for BTT or DT | DT | DT | BTT | DT | DT | DT | DT | DT |
Gram-positive organism(s) identified with previous infection | MRSA | Staphylococcus lugdunensis and Staphylococcus epidermidis | MRSA | MRSA | MRSA and C. Striatium | MSSA | MRSA | S epidermidis and Corynebacterium jeikeium |
Other organism(s) identified with previous infection | None | None | Pseudomonas spp | Proteus mirabilis | None | None | None | None |
Previous suppression regimen(s) | Doxycycline | Doxycycline and SMX/TMP | Vancomycin | Doxycycline | Doxycycline and minocycline | Cephalexin, doxycycline, SMX/TMP, and linezolid | SMX/TMP and doxycycline | None |
Reason for switching suppression to DAL | Breakthrough infection | Breakthrough infection | Breakthrough infection | Breakthrough infection | Breakthrough infection | Adverse effects to oral suppression | Breakthrough infection | NA |
Frequency of DAL administration | Biweekly | Biweekly | Biweekly | Biweekly | Biweekly | Weekly, switched to biweekly after 2 mo | Biweekly | Biweekly |
Reason for switching DAL to another agent, if applicable | Breakthrough infection | Breakthrough infection | NA | Breakthrough infection | Breakthrough infection | Clinically stable | Breakthrough infection | Clinically stable |
Agent DAL was switched to | Linezolid, ceftaroline | Linezolid | NA | Daptomycin and ceftaroline | Vancomycin and daptomycin | Doxycycline | Daptomycin | Minocycline |
Gram-positive organism(s) identified with breakthrough infection, if applicable | MRSA | MRSA | NA | MRSA | C. Striatium | NA | MRSA | NA |
Time to first LVAD-related infection after DAL suppression initiation, d | 112 | 273 | NA | 226 | 251 | NA | 29 | NA |
Total duration of DAL for suppression, d | 127 | 273 | 212 | 226 | 372 | 227 | 293 | 107 |
Missed or delayed infusions | No | No | No | Yes | Yes | No | No | No |
Outcome | Continued | Continued | Heart transplantation | LVAD exchange and oral suppression | Continued | Oral suppression | LVAD exchange and oral suppression | Oral suppression |
Abbreviations: BTT, bridge to transplant; CrCl, creatinine clearance; DAL, dalbavancin; DT, destination therapy; F, female; ICM, ischemic cardiomyopathy; LVAD, left ventricular assist device; M, male; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible S aureus; NA, not applicable; NICM, nonischemic cardiomyopathy; PPCM, peripartum cardiomyopathy; SMX/TMP, sulfamethoxazole-trimethoprim.