Dalbavancin Reduces Hospital Stay and Improves Productivity for Patients with Acute Bacterial Skin and Skin Structure Infections: The ENHANCE Trial.

Autor: McCarthy MW; Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY, USA. mwm9004@med.cornell.edu., Keyloun KR; Global Health Economics and Outcomes Research, Allergan plc, Irvine, CA, USA., Gillard P; Global Health Economics and Outcomes Research, Allergan plc, Irvine, CA, USA., Choi JJ; Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY, USA., Pickell N; Department of Medicine, Infectious Diseases, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY, USA., Copp R; ICON plc, Dublin, Ireland., Walsh TJ; Departments of Medicine, Pediatrics, and Microbiology and Immunology, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY, USA.
Jazyk: angličtina
Zdroj: Infectious diseases and therapy [Infect Dis Ther] 2020 Mar; Vol. 9 (1), pp. 53-67. Date of Electronic Publication: 2019 Nov 11.
DOI: 10.1007/s40121-019-00275-4
Abstrakt: Introduction: Admissions for acute bacterial skin and skin structure infections (ABSSSI) are often prolonged because of intravenous (IV) antibiotics. Use of a long-acting IV antibiotic may reduce length of stay (LOS) on a hospitalist service. The ENHANCE ABSSSI trial sought to determine the impact on LOS and work productivity in patients treated with a long-acting IV antibiotic, dalbavancin, vs. usual care at an urban tertiary-care center.
Methods: A single-center, pre- vs. post-period pragmatic trial at Weill-Cornell Medical Center assessed usual care for consecutively enrolled admitted ABSSSI patients during an observational period (pre-period). Identification and treatment of eligible admitted ABSSSI patients with dalbavancin were implemented in the post-period. Those with life-threatening infections, requiring multiple antibiotics/intensive care, or with unstable comorbidities were excluded. Outcomes were assessed over a 44-day follow-up period.
Results: Of 48 and 43 patients enrolled, respectively, in the pre- and post-periods, mean infection-related LOS was reduced in the post-period (3.2 days vs. 4.8 days; P = 0.003). Similar results were found in an adjusted LOS analysis. Work productivity and activity impairment outcomes significantly improved in the post-period (P ≤ 0.01). Complete response rates were similar: 50% (pre-period) and 57% (post-period). Among AEs identified, 17% (n = 7) were found to have possible causal relation to dalbavancin in the post-period. Few AEs were serious (n = 3; 7% post-period versus n = 1; 2% pre-period).
Conclusion: After implementing the ENHANCE ABSSSI pathway, LOS was significantly reduced by almost 2 days, with potential improvements in work productivity and ability to complete daily activities.
Trial Registration: ClinicalTrials.gov identifier, NCT03233438.
Funding: Allergan plc.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje