Loading
Life sciences · Journal article
Asm Case Reports · September 9, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a case report of successful off-label dalbavancin monotherapy in an immunocompromised patient with B. cereus bacteremia secondary to PICC line infection. The patient achieved clinical cure and earlier discharge after a single 1,500 mg intravenous dose, but the evidence is limited to one case and does not establish efficacy or safety beyond this individual scenario.
Case report. One 58-year-old immunocompromised woman with invasive ductal breast cancer on active chemotherapy, presenting with febrile neutropenia and B. cereus bacteremia from PICC line infection. Intervention: Single intravenous dose of dalbavancin 1,500 mg following PICC line removal. n = 1.
Single 1,500 mg intravenous dalbavancin dose administered in immunocompromised patient with B. cereus bacteremia Blood cultures cleared by day 5 after PICC line removal Patient remained clinically well at 2.5-week, 30-day, 60-day, and 90-day follow-up without recurrence
No pharmacokinetic or tissue penetration data provided to support mechanism
This case illustrates a potential off-label use of dalbavancin in a difficult-to-treat situation with logistical barriers to standard care, but a single successful case does not establish evidence for practice adoption. Further controlled studies would be needed before recommending this approach more broadly.
A single immunocompromised patient case report describing off-label dalbavancin use for B. cereus bacteremia; no comparator, no control group, and the authors themselves call for further study.
As stated by the source record.
Quoted from the source exactly as published.
This case illustrates a potential off-label use of dalbavancin in a difficult-to-treat situation with logistical barriers to standard care, but a single successful case does not establish evidence for practice adoption. Further controlled studies would be needed before recommending this approach more broadly.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
ABSTRACT Background Dalbavancin’s pharmacokinetics (long half-life, high tissue penetration, once-weekly dosing) make it an attractive alternative for patients with barriers to outpatient parenteral antimicrobial therapy or at risk for line-related complications. In this case, we used dalbavancin to promote timely discharge for an immunocompromised patient who experienced Bacillus cereus bacteremia due to a peripherally inserted central catheter (PICC) line-associated infection. Although B. cereus is known to cause line-related infections, we present a novel clinical case highlighting the successful use of dalbavancin in an immunocompromised patient with B. cereus bacteremia, and this approach also facilitated earlier discharge. Case Summary A 58-year-old woman with invasive ductal breast cancer on chemotherapy (docetaxel, carboplatin, trastuzumab, pertuzumab), mechanical aortic valve replacement, and other comorbidities presented with febrile neutropenia 2 weeks after her fifth chemotherapy cycle. A month prior, she had completed vancomycin for a suspected port infection. Admission laboratory values revealed pancytopenia (white blood cell count [WBC] 1.7 × 10⁹/L, absolute neutrophil count [ANC] 0.53 × 10⁹/L, hemoglobin 7.8 g/dL, and platelets 51 × 10⁹/L). Both sets of blood cultures obtained prior to empiric vancomycin grew B. cereus, with positive cultures throughout day 3 despite treatment. A transthoracic and transesophageal echocardiography excluded endocarditis. The PICC line was removed on day 2; blood cultures cleared by day 5, and neutropenia resolved on day 7. Given two prior catheter-related infections and logistical challenges with weekend discharge planning, the patient received a single 1,500 mg dose of intravenous dalbavancin rather than receiving a new line and continuing prolonged intravenous therapy. This facilitated discharge 4 days earlier than anticipated. At 2.5-week follow-up and visits at 30, 60, and 90 days, the patient remained clinically well without recurrence of infection. Conclusion This case highlights successful off-label use of dalbavancin in a complex case, suggesting that its use in such cases warrants further studies, especially when standard regimens can be logistically challenging.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.