Use of Dalbavancin in the Treatment of Infected Bone Nonunion: A Report of Two Cases

Case Report

Volume 5, Issue 2

Use of Dalbavancin in the Treatment of Infected Bone Nonunion: A Report of Two Cases

Morgan C. Roche^1*, Mohammed Bashier¹, Mihir Sharma¹, Hongkai Bao², Priya Nori³ and Mani D. Kahn⁴

¹Albert Einstein College of Medicine, Bronx, New York, USA
²Montefiore Einstein, Department of Pharmacy, Bronx, New York, USA
³Montefiore Einstein, Department of Medicine, Division of Infectious Diseases, Bronx, New York, USA
⁴Montefiore Einstein, Department of Orthopaedic Surgery, Bronx, New York, USA

^*Corresponding author: Morgan C. Roche, Albert Einstein College of Medicine, Bronx, New York, USA. E-mail: morgan.roche@einsteinmed.edu

Received: June 09, 2026; Accepted: June 24, 2026; Published: July 05, 2026

Citation: Roche MC, Bashier M, Sharma M, et al. Use of Dalbavancin in the Treatment of Infected Bone Nonunion: A Report of Two Cases. Case Rep Orthop Surg J. 2026; 5(2): 164.

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Abstract

We present the cases of two female patients, ages 30 and 45, who were treated for culture-confirmed gram-positive infected nonunions of the leg with irrigation and debridement (I&D) by the Synthes Reamer-Irrigator-Aspirator (RIA) system followed by placement of an antibiotic-laden intramedullary nail (IMN). They were treated with two doses of intravenous (IV) dalbavancin (1.5g), one week apart. Both patients recovered from their infections and are doing well. These cases highlight that treatment with IV dalbavancin, I&D with RIA, and antibiotic IMN placement is a viable treatment option for septic nonunions where traditional antibiotic regimens are less desirable.

Keywords: Dalbavancin; Long bone nonunion; Infected nonunion; Septic nonunion; Antimicrobial stewardship; Barriers to outpatient parenteral antibiotic therapy (OPAT)

Article Details

Use of Dalbavancin in the Treatment of Infected Bone Nonunion: A Report of Two Cases