Publication: DALBACEN cohort: dalbavancin as consolidation therapy in patients with endocarditis and/or bloodstream infection produced by gram-positive cocci.
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Date
2019-10-19
Authors
Hidalgo-Tenorio, Carmen
Vinuesa, David
Plata, Antonio
Martin Dávila, Pilar
Iftimie, Simona
Sequera, Sergio
Loeches, Belén
Lopez-Cortés, Luis Eduardo
Fariñas, Mari Carmen
Fernández-Roldan, Concepción
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Abstract
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. 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. 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€). 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.
Description
MeSH Terms
Aged
Anti-Bacterial Agents
Cost-Benefit Analysis
Drug-Related Side Effects and Adverse Reactions
Endocarditis, Bacterial
Female
Gram-Positive Bacterial Infections
Humans
Length of Stay
Male
Middle Aged
Retrospective Studies
Sepsis
Teicoplanin
Treatment Outcome
Anti-Bacterial Agents
Cost-Benefit Analysis
Drug-Related Side Effects and Adverse Reactions
Endocarditis, Bacterial
Female
Gram-Positive Bacterial Infections
Humans
Length of Stay
Male
Middle Aged
Retrospective Studies
Sepsis
Teicoplanin
Treatment Outcome
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CIE Terms
Keywords
Bloodstream infection, Dalbavancin, Endocarditis