DALBACEN cohort: dalbavancin as consolidation therapy in patients with endocarditis and/or bloodstream infection produced by gram-positive cocci

Annals of Clinical Microbiology and Antimicrobials

Carmen Herrero¹  Carmen Hidalgo-Tenorio²  Sergio Sequera²  Rosario Javier-Martinez²  Juan Pasquau²  Samantha E. De Jesus²  Concepción Fernández-Roldan²  Jose Maria Miró³  Patricia Muñoz⁴  Francisco Javier Martínez-Marcos⁵  Mari Carmen Fariñas⁶  Pilar Martin Dávila⁷  Antonio Plata⁸  Simona Iftimie⁹  Belén Loeches^1,10  David Vinuesa^1,11  Luis Eduardo Lopez-Cortés^1,12  Elena Bereciartua^1,13  Maria del Mar Arenas-Miras^1,14 

[1]Complejo Hospitalario de Jaén

[2]Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves

[3]Hospital Clínic

[4]Hospital Gregorio Marañón

[5]Hospital Juan Ramón Jiménez

[6]Hospital Marqués de Valdecillas

[7]Hospital Ramón y Cajal

[8]Hospital Regional de Málaga

[9]Hospital Universitari Sant Joan

[10]Hospital Universitario La Paz

[11]Hospital Universitario San Cecilio

[12]Hospital Universitario Virgen Macarena

[13]Hospital Universitario de Cruces

[14]Hospital del Mar

关键词: Endocarditis;    Bloodstream infection;    Dalbavancin;   

DOI  :  10.1186/s12941-019-0329-6

来源: DOAJ

【 摘 要 】

Abstract Objectives To analyse the effectiveness of dalbavancin (DBV) in clinical practice as consolidation therapy in patients with bloodstream infection (BSI) and/or infective endocarditis (IE) produced by gram-positive cocci (GPC), as well as its safety and pharmacoeconomic impact. Methods A multicentre, observational and retrospective study was conducted of hospitalised patients with IE and/or BSI produced by GPC who received at least one dose of DBV. Clinical response was assessed during hospitalization, at 3 months and at 1 year. Results Eighty-three patients with median age of 73 years were enrolled; 73.5% were male; 59.04% had BSI and 49.04% IE (44.04% prosthetic valve IE, 32.4% native IE, 23.5% pacemaker lead). The most frequently isolated microorganism was Staphylococcus aureus in BSI (49%) and coagulase-negative staphylococci in IE (44.1%). All patients with IE were clinically cured in hospital; at 12 months, there was 2.9% loss to follow-up, 8.8% mortality unrelated to IE, and 2.9% therapeutic failure rate. The percentage effectiveness of DBV to treat IE was 96.7%. The clinical cure rate for BSI was 100% during hospital stay and at 3 months; there were no recurrences or deaths during the follow-up. No patient discontinued treatment for adverse events. The saving in hospital stay was 636 days for BSI (315,424.20€) and 557 days for IE (283,187.45€). Conclusions DBV is an effective consolidation antibiotic therapy in clinically stabilized patients with IE and/or BSI. It proved to be a cost-effective treatment, reducing the hospital stay, thanks to the pharmacokinetic/pharmacodynamic profile of this drug.

【 授权许可】

Unknown