Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality

Antibiotics

Mar de Pablo-Miró¹  María del Mar Arenas-Miras¹  Sergi Pujol-Ruiz¹  Juan P. Horcajada¹  Inmaculada López-Montesinos¹  Albert Anglès²  Santiago Grau³  Simona Iftimie⁴  Xavier Duran-Jordà⁵ 

[1] Department of Infectious Diseases, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;Documentation Service, Hospital del Mar, 08003 Barcelona, Spain;Faculty of Health and Life Sciencies, Universitat Pompeu Fabra, 08003 Barcelona, Spain;Infectious Diseases Service, Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain;Statistics Service, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;

关键词: dalbavancin;    hospital stay;    effectiveness;    mortality;    gram-positive;    multidrug-resistant gram-positive cocci;   

DOI  :  10.3390/antibiotics10111296

来源: DOAJ

【 摘 要 】

Dalbavancin is a new antibiotic that is effective against Gram-positive microorganisms, including methicillin-resistant Staphylococci, and offers the possibility of administering intravenous therapy once weekly in an ambulatory setting. We conducted a multicenter observational case-control study, comparing all patients who received dalbavancin (cases) with hospitalized patients who were treated instead with daptomycin, linezolid or vancomycin (controls), based on clinical diagnosis, main microorganism involved, and age. The primary outcome was the length of hospital stay after starting the study antimicrobial. Secondary outcomes were 7-day and 30-day efficacy, 30-day mortality, 90-day recurrence, 90-day and 6-month hospitalization, presence of adverse events and healthcare-associated infections; 161 patients (44 cases and 117 controls) were included. Bivariate analysis showed that dalbavancin reduced the total length of hospital stay (p < 0.001), with fewer 90-day recurrences (p = 0.005), 6-month hospitalizations related to the same infection (p = 0.004) and non-related hospitalizations (p = 0.035). Multivariate analyses showed that length of hospital stay was significantly shorter in patients treated with dalbavancin (−12.05 days 95% CI [−17.00, −7.11], p < 0.001), and 30-day efficacy was higher in the dalbavancin group (OR 2.62 95% CI [1.07, 6.37], p = 0.034). Although sample size of the study may be a limitation, we can conclude that Dalbavancin is a useful antimicrobial drug against Gram-positive infections, including multidrug-resistant pathogens, and allows for a remarkable reduction in length of hospital stay with greater 30-day efficacy.

【 授权许可】

Unknown