French national cohort of first use of dalbavancin: A high proportion of off-label use

Autor: Aurélien Dinh, Clara Duran, Patricia Pavese, Lydie Khatchatourian, Boris Monnin, Alexandre Bleibtreu, Eric Denis, Cédric Etienne, Nicolas Rouanes, Rafael Mahieu, Frédérique Bouchand, Benjamin Davido, Romain Lotte, Philippe Cabaret, Fabrice Camou, Pascal Chavanet, Assi Assi, Silvia Limonta, Catherine Lechiche, Raphaëlle Riou, Johan Courjon, Gabriela Illes, Flore Lacassin-Beller, Eric Senneville, Chandra Adjodah, Nicolas Baclet, Odile Bouchard, David Boutoille, Guillaume Brunin, Daniel Carbognani, Pierre Delobel, Hélène Ferrand, Yves Imbert, Sophie Leautez-Nainville, Vincent Le Moing, Bouchra Loutfi, Natacha Mrozek, Nicolas Rouzic, Jean-Philippe Talarmin, Pierre Tattevin, Pierre Weyrich
Přispěvatelé: Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service des Maladies Infectieuses et Tropicales [CHU Raymond Poincaré], Hôpital Raymond Poincaré [AP-HP], CHU Grenoble, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université d'Angers (UA), Service de Maladies Infectieuses et Tropicales [CHU Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
Rok vydání: 2019
Předmět:
Adult
Male
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical)
medicine.medical_specialty
medicine.drug_class
[SDV]Life Sciences [q-bio]
Antibiotics
Microbial Sensitivity Tests
Glycopeptide antibiotic
medicine.disease_cause
03 medical and health sciences
0302 clinical medicine
Vancomycin
Surveys and Questionnaires
Internal medicine
medicine
Humans
Endocarditis
Pharmacology (medical)
030212 general & internal medicine
Retrospective Studies
0303 health sciences
030306 microbiology
business.industry
Soft Tissue Infections
Dalbavancin
Retrospective cohort study
Off-Label Use
General Medicine
Middle Aged
Staphylococcal Infections
medicine.disease
Anti-Bacterial Agents
3. Good health
Regimen
Treatment Outcome
Infectious Diseases
Staphylococcus aureus
Female
France
Teicoplanin
business
medicine.drug
Zdroj: International Journal of Antimicrobial Agents
International Journal of Antimicrobial Agents, 2019, 54, pp.668-672. ⟨10.1016/j.ijantimicag.2019.08.006⟩
ISSN: 0924-8579
DOI: 10.1016/j.ijantimicag.2019.08.006
Popis: Dalbavancin is a glycopeptide antibiotic with a long half-life, recently marketed in Europe for skin and soft-tissue infections (SSTIs), but its real-life use is not well known. The aim of this study was to describe all first prescriptions in France over an 16-month period. A retrospective study on all adult patients receiving at least one dose of dalbavancin from 1 June 2017 to 31 September 2018 was performed (75 patients from 29 French hospitals). Data were collected via a standard questionnaire. Failure was defined as persistence or reappearance of signs of infection, and/or switch to suppressive antibiotic treatment, and/or death from infection. The main indications were bone and joint infection (BJI) (64.0%), endocarditis (25.3%), and SSTI (17.3%). The main bacteria involved were Staphylococcus aureus (51.4%), including methicillin-resistant S. aureus (MRSA) (19.4%), and coagulase-negative staphylococci (44.4%). Median minimum inhibitory concentrations (MICs) for staphylococci to vancomycin and dalbavancin ranged from 0.875-2.0 mg/L and 0.032-0.064 mg/L, respectively. Dalbavancin was used after a mean of 2.3 ± 1.2 lines of antimicrobial treatment. The main treatment regimens for dalbavancin were a two-dose regimen (1500 mg each) in 38 cases (50.7%) and a single-dose regimen (1500 mg) in 13 cases (17.3%). Overall, at the patient's last visit, clinical cure was observed in 54/68 patients, whilst failure was observed in 14/68 patients. First use of dalbavancin in France was mostly off-label. Most were due to BJI, often as rescue therapy for severe infections. Even in off-label situations, dalbavancin appears safe and effective.
Databáze: OpenAIRE
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