Extended-interval dosing protocol completes IV antibiotic course in three visits

A single-centre prospective implementation study (n=101, Italy) evaluated a therapeutic drug monitoring (TDM)-guided dalbavancin dosing protocol for chronic bone and joint infections delivered within an outpatient parenteral antimicrobial therapy (OPAT) programme [Primary Study]. Administrations were fixed on Days 1, 8 and 43, with pharmacokinetic-model-guided interval individualisation between patients. Pharmacological target attainment was achieved in 89.6% of administrations, clinical effectiveness in 75.3% of patients completing therapy, and only 3% of patients discontinued due to adverse events.

This is a single-centre Italian implementation study; the source material provides no international benchmark beyond itself, and none is asserted here. Read on its own terms, it demonstrates that a full course of intravenous antibiotic therapy for a chronic infection can be delivered in three administration visits under monitored, individualised dosing, rather than the more frequent visit schedules conventional regimens typically require.

For OPAT services managing patients who face barriers to frequent attendance — whether through geography, workforce capacity, or patient preference — this protocol indicates that carefully monitored, extended-interval dosing can substantially reduce the number of administration visits needed to complete treatment, without an increase in adverse-event-related discontinuation.