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Dalbavancin in the treatment of different gram-positive infections: a real-life experience.
Int J Antimicrob Agents. 2017 Nov 24;:
Authors: Bouza E, Valerio M, Soriano A, Morata L, Carus EG, Rodríguez-González C, Hidalgo-Tenorio MC, Plata A, Muñoz P, Vena A, DALBUSE study group (Dalbavancina: Estudio de su uso clinico en España)
Abstract
Dalbavancin is a lipoglycopeptide with a very prolonged half-life that enables treatments with a single IV administration that has been approved to treat complicated skin and soft tissue infections. Information on the efficacy and safety of Dalbavancin in other situations is very scarce. This retrospective study includes adult patients who received at least one dose of Dalbavancin between 2016 and 2017 in 29 institutions in Spain. Primary objective was to report the use of Dalbavancin in clinical practice including its efficacy and tolerability. We also tried to evaluate the potential impact of Dalbavancin on reduction of length of hospital stay and hospital costs. A total of 69 patients received Dalbavancin during the study period (58% male, median age 63.5 years). Dalbavancin was used to treat prosthetic joint infections (29.0%), acute bacterial skin and skin structure infection (21.7%), osteomyelitis (17.4%) and catheter-related bacteraemia (11.6%). These infections were mainly caused by Staphylococcus aureus (27 isolates), coagulase negative staphylococci (21 isolates) and Enterococcus spp. (11 isolates). All but two patients received previous antibiotics for a median of 18 days. Dalbavancin was administered for a median of 21 days (range 7-168 days) and concomitant antimicrobial therapy was prescribed to 25 patients (36.2%). The overall clinical success rate of Dalbavancin was 84.1%. Adverse events, mainly mild in intensity, were reported in 9 patients. Overall, we estimated that Dalbavancin reduced hospitalisation by 1160 days, with an estimated overall cost reduction of €211,481 (€3064 per patient). Dalbavancin appears to be an effective therapy for many serious Gram-positive infections.
PMID: 29180276 [PubMed - as supplied by publisher]