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- Title
Dalbavancin Sequential Therapy for Gram-Positive Bloodstream Infection: A Multicenter Observational Study.
- Authors
Rebold, Nicholas; Alosaimy, Sara; Pearson, Jeffrey C.; Dionne, Brandon; Taqi, Ahmad; Lagnf, Abdalhamid; Lucas, Kristen; Biagi, Mark; Lombardo, Nicholas; Eudy, Joshua; Anderson, Daniel T.; Mahoney, Monica V.; Kufel, Wesley D.; D'Antonio, Joseph A.; Jones, Bruce M.; Frens, Jeremy J.; Baumeister, Tyler; Geriak, Matthew; Sakoulas, George; Farmakiotis, Dimitrios
- Abstract
Introduction: Long-acting lipoglycopeptides such as dalbavancin may have utility in patients with Gram-positive bloodstream infections (BSI), particularly in those with barriers to discharge or who require prolonged parenteral antibiotic courses. A retrospective cohort study was performed to provide further multicenter real-world evidence on dalbavancin use as a sequential therapy for Gram-positive BSI. Methods: One hundred fifteen patients received dalbavancin with Gram-positive BSI, defined as any positive blood culture or diagnosed with infective endocarditis, from 13 centers geographically spread across the United States between July 2015 and July 2021. Results: Patients had a mean (SD) age of 48.5 (17.5) years, the majority were male (54%), with many who injected drugs (40%). The most common infection sources (non-exclusive) were primary BSI (89%), skin and soft tissue infection (SSTI) (25%), infective endocarditis (19%), and bone and joint infection (17%). Staphylococcus aureus accounted for 72% of index cultures, coagulase-negative Staphylococcus accounted for 18%, and Streptococcus species in 16%. Dalbavancin started a median (Q1–Q3) of 10 (6–19) days after index culture collection. The most common regimen administered was dalbavancin 1500 mg as one dose for 50% of cases. The primary outcome of composite clinical failure occurred at 12.2%, with 90-day mortality at 7.0% and 90-day BSI recurrence at 3.5%. Conclusions: Dalbavancin may serve as a useful tool in facilitating hospital discharge in patients with Gram-positive BSI. Randomized controlled trials are anticipated to validate dalbavancin as a surrogate to current treatment standards.
- Subjects
UNITED States; INFECTIVE endocarditis; JOINT infections; SOFT tissue infections; RANDOMIZED controlled trials; SCIENTIFIC observation; STAPHYLOCOCCUS aureus
- Publication
Infectious Diseases & Therapy, 2024, Vol 13, Issue 3, p565
- ISSN
2193-8229
- Publication type
Article
- DOI
10.1007/s40121-024-00933-2