1. Dalbavancin in the treatment of different gram-positive infections: a real-life experience
- Author
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Emilio Bouza, Maricela Valerio, Alex Soriano, Laura Morata, Enrique García Carus, Carmen Rodríguez-González, Ma Carmen Hidalgo-Tenorio, Antonio Plata, Patricia Muñoz, Antonio Vena, Ana Alvarez-Uria, Ana Fernández-Cruz, Ascensión Arroyo Nieto, Arturo Artero, José María Barbero Allende, Enrique Bernal Morell, Francisco Javier Candel-González, Laura Castelo, Javier Cobo, Maria del Carmen Gálvez Contreras, Roberto Güerri Fernández, Juan Pablo Horcajada, Pablo Guisado-Vasco, Juan Emilio Losa, Rafael Hervás, Simona Mihaela Iftimie, Manuel Enrique Jiménez Mejías, Francisco Jover, José Luis Lamas Ferreiro, Ana B. Lozano Serrano, Eduardo Malmierca, Mar Masiá, Maria Rosa Oltra Sempere, Alicia Rico Nieto, Dolors Rodriguez-Pardo, Sergio J. Rodriguez Alvarez, Rafael San Juan, Cristina Sarria Cepeda, María Antonia Sepúlveda Berrocal, Beatriz Sobrino, and Luisa Sorlí
- Subjects
0301 basic medicine ,Microbiology (medical) ,Male ,Methicillin-Resistant Staphylococcus aureus ,medicine.medical_specialty ,Prosthesis-Related Infections ,Lipoglycopeptide ,medicine.drug_class ,Gram-positive infection ,Cost-Benefit Analysis ,030106 microbiology ,Antibiotics ,Microbial Sensitivity Tests ,Skin and soft-tissue infection ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Adverse effect ,Aged ,Retrospective Studies ,business.industry ,Osteomyelitis ,Soft Tissue Infections ,Dalbavancin ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Tolerability ,chemistry ,Spain ,Concomitant ,Catheter-Related Infections ,Female ,Staphylococcal Skin Infections ,Teicoplanin ,business ,Enterococcus - Abstract
Dalbavancin is a lipoglycopeptide with a very prolonged half-life enabling treatment with a single intravenous 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 included adult patients who received at least one dose of dalbavancin between 2016 and 2017 in 29 institutions in Spain. The primary objective was to report the use of dalbavancin in clinical practice, including its efficacy and tolerability. The potential impact of dalbavancin on reducing the length of hospital stay and hospital costs was also evaluated. A total of 69 patients received dalbavancin during the study period (58.0% male; median age 63.5 years). Dalbavancin was used to treat prosthetic joint infection (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 (24 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 nine patients. Overall, dalbavancin was estimated to reduce 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.
- Published
- 2017