Anthony T.

Age 30. Unemployed.

Anthony T. 30-year-old male with a 10-year history of recreational IV drug abuse
Not an actual patient. For illustrative purposes only.

Patient Profile

  • 30-year-old male with a 10-year history of IV drug abuse
  • Spends majority of the time on the street
  • Medical history is unknown
  • Has little social support

Presentation

  • Presents at hospital with recurrent infection of injection site

Assessment

  • Increased erythema of upper left arm, erythema of approximately 150 cm2
  • Significant pus present
  • Temperature of 39.0 °C
  • BP 125/85; HR 100
  • WBC count of >13,000 cells/mm3
  • CrCl of 109 ml/min

Diagnosis

  • Major cutaneous abscess, treat for S. aureus

Treatment Considerations

  • This patient would most likely be deemed unsuitable for out-patient treatment14.
  • When using dalbavancin a full course of treatment can be administered without a PICC line with a single 30 minute infusion13.
  • In the single dose study a total of 30.4%
    of patients were intravenous drug users and 16.2% had hepatitis9.

Dalbavancin as a single-dose or 2-dose regimen had similar efficacy for the treatment of ABSSSI in persons who inject drugs (PWID) and non-PWID populations.

10 MW Dunne et al. Clinical Infectious Diseases. 2016;62(5):545–51x
13 Tatarkiewicz J, et al. New agents approved for treatment of acute staphylococcal skin infections. Archives of Medical Science : AMS. 2016;12(6):1327-1336. doi:10.5114/aoms.2016.59838.
14 Chapman Ann L N. Outpatient parenteral antimicrobial therapy BMJ 2013; 346: f1585
19. Gonzalez PL, et al. Drugs Context. 2018 Dec 11;7:212559.