Single-Dose Dalbavancin and Patient Satisfaction in an Outpatient Setting in the Treatment of Acute Bacterial Skin and Skin Structure Infections.
J Glob Antimicrob Resist. 2019 Feb 20;:
Authors: Rappo U, Gonzalez PL, Puttagunta S, Akinapelli K, Keyloun K, Gillard P, Liu Y, Dunne MW
OBJECTIVES: Treatment of acute bacterial skin and skin structure infections (ABSSSI) in the outpatient setting has potential advantages. We performed a subanalysis of outcomes for patients treated as outpatients versus inpatients with dalbavancin, a long-acting lipoglycopeptide, in a phase 3 clinical trial of ABSSSI.
METHODS: The study was a double-blind trial of patients with ABSSSI randomized to receive dalbavancin 1500 mg intravenously as a single dose or 2 doses (1000 mg followed by 500 mg a week later). The primary endpoint was ≥20% reduction in erythema at 48 to 72 hours after start of therapy. Patient satisfaction and preference for antibiotic treatment and care setting was measured by the 10-item Skin and Soft Tissue Infection (SSTI) questionnaire at Day 14.
RESULTS: There were 698 patients randomized; 386 were treated as outpatients and 312 were treated as inpatients. Outpatients were more likely to be younger, and have major abscess or traumatic wound infection; inpatients were more likely to have cellulitis as the type of ABSSSI, meet systemic inflammatory response syndrome criteria, and have elevated plasma lactate at baseline. Efficacy and safety outcomes at 48-72 hours, Day 14 and Day 28 were similar between patients treated in the outpatient and inpatient setting with either the single-dose or the 2-dose regimen. Outpatients reported significantly greater convenience and satisfaction with antibiotic treatment and care setting compared with inpatients (P < 0.001).
CONCLUSIONS: Single-dose dalbavancin is an effective treatment option for outpatients with ABSSSI and is associated with a high degree of patient treatment satisfaction and convenience.
PMID: 30797084 [PubMed - as supplied by publisher]