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

Autor: Hidalgo-Tenorio C; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain. chidalgo72@gmail.com., Vinuesa D; Hospital Universitario San Cecilio, Granada, Spain., Plata A; Hospital Regional de Málaga, Málaga, Spain., Martin Dávila P; Hospital Ramón y Cajal, Madrid, Spain., Iftimie S; Hospital Universitari Sant Joan, Reus, Spain., Sequera S; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain., Loeches B; Hospital Universitario La Paz, Madrid, Spain., Lopez-Cortés LE; Hospital Universitario Virgen Macarena, Seville, Spain., Fariñas MC; Hospital Marqués de Valdecillas, Santander, Spain., Fernández-Roldan C; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain., Javier-Martinez R; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain., Muñoz P; Hospital Gregorio Marañón, Madrid, Spain., Arenas-Miras MDM; Hospital del Mar, Barcelona, Spain., Martínez-Marcos FJ; Hospital Juan Ramón Jiménez, Huelva, Spain., Miró JM; Hospital Clínic, Barcelona, Spain., Herrero C; Complejo Hospitalario de Jaén, Jaén, Spain., Bereciartua E; Hospital Universitario de Cruces, Bilbao, Spain., De Jesus SE; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain., Pasquau J; Department of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas no 2, 18014, Granada, Spain.
Jazyk: angličtina
Zdroj: Annals of clinical microbiology and antimicrobials [Ann Clin Microbiol Antimicrob] 2019 Oct 19; Vol. 18 (1), pp. 30. Date of Electronic Publication: 2019 Oct 19.
DOI: 10.1186/s12941-019-0329-6
Abstrakt: 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.
Databáze: MEDLINE
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