Outpatient treatment of osteomyelitis with telavancin.

Autor: Schroeder CP; Healix Infusion Therapy, Inc., 14140 Southwest Freeway, Suite 400, Sugar Land, TX 77478, USA., Van Anglen LJ; Healix Infusion Therapy, Inc., 14140 Southwest Freeway, Suite 400, Sugar Land, TX 77478, USA. Electronic address: Lvananglen@healix.net., Dretler RH; Infectious Disease Specialists of Atlanta, P.C., 2665 North Decatur Road, Suite 330, Decatur, GA 30033, USA., Adams JS; Knoxville Infectious Disease Consultants, P.C., 2210 Sutherland Ave., Suite 110, Knoxville, TN 37919, USA., Prokesch RC; Infectious Diseases Associates, 6285 Garden Walk Blvd., Suite A, Riverdale, GA 30274, USA., Luu Q; Central Georgia Infectious Diseases Associates, 458 Hemlock Street, Suite 200, Macon, GA 31201, USA., Krinsky AH; Infectious Diseases Associates, 1425 S. Osprey Ave., Suite 1, Sarasota, FL 34239, USA.
Jazyk: angličtina
Zdroj: International journal of antimicrobial agents [Int J Antimicrob Agents] 2017 Jul; Vol. 50 (1), pp. 93-96. Date of Electronic Publication: 2017 Apr 26.
DOI: 10.1016/j.ijantimicag.2017.01.034
Abstrakt: Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres. Medical records of 60 patients receiving telavancin for osteomyelitis in 22 physician office infusion centres from 2010 to 2011 and 2013 to 2015 were reviewed. Of these, 60% were treated without hospitalisation, 37% had orthopaedic hardware and 56% had concurrent infections. Staphylococcus aureus was the most common pathogen (78%), primarily methicillin-resistant. The median duration of telavancin treatment in the outpatient setting was 21 days (range 3-105 days). Telavancin was used as first-line therapy in 32% of cases, following prior antibiotic failure in 47% and due to intolerance to previous agents in 22%, predominantly daptomycin or vancomycin. The telavancin dose was 10 mg/kg/day, adjusted for renal function in 25% of patients. The majority of patients self-administered telavancin at home via an elastomeric infusion pump. Overall clinical success was 73%. No significant differences in outcomes were observed with the presence of hardware, concurrent infection, concomitant therapies or type of osteomyelitis. Telavancin-associated adverse events occurred in 57%, with discontinuation in three patients (5%). These data demonstrate the effective and safe OPAT use of telavancin, providing an alternative for successful treatment of patients with osteomyelitis.
(Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.)
Databáze: MEDLINE
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