Int J Antimicrob Agents. 2023 May 7:106842. doi: 10.1016/j.ijantimicag.2023.106842. Online ahead of print.
BACKGROUND: The purpose was to compare dalbavancin to standard of care (SOC) for patients with S. aureus bacteremia (SAB) who were unable to receive outpatient parenteral antimicrobial therapy (OPAT).
METHODS: This retrospective cohort compared readmission rates related to the index infection between patients treated with dalbavancin or SOC for SAB. Patients at least 18 years old seen by the ID consult service who received at least one dose of dalbavancin or at least one week of SOC parenteral antibacterials as directed therapy for SAB at the time of discharge were included. The SOC group consisted of patients transferred from the main hospital to one of the post-acute care facilities to complete parenteral antibacterials. The primary outcome was readmission rates within 30 days after completion of therapy. Secondary outcomes included readmission rates within 90 days after completion of therapy as well as antibacterial regimen adherence.
RESULTS: 27 patients received dalbavancin, and 27 patients received SOC. Baseline demographics were comparable between groups, though more patients in the SOC group had indwelling prostheses or hardware (4% vs 22%). The majority of SAB was caused by MSSA (56% vs 59%). Readmission rates in the dalbavancin group were similar to the SOC group within 30 days (15% vs 22%, p=0.484) and 90 days (19% vs 22%, p=0.735) after completion of therapy. Adherence was significantly higher among patients treated with dalbavancin (85% vs 44%, p < 0.001).
CONCLUSIONS: Dalbavancin offers similar clinical outcomes to SOC for patients with SAB who are unable to receive OPAT.
PMID:37160242 | DOI:10.1016/j.ijantimicag.2023.106842