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DALBACEN cohort: dalbavancin as consolidation therapy in patients with endocarditis and/or bloodstream infection produced by gram-positive cocci.
Annals of Clinical Microbiology and Antimicrobials ( IF 4.6 ) Pub Date : 2019-10-19 , DOI: 10.1186/s12941-019-0329-6
Carmen Hidalgo-Tenorio 1 , David Vinuesa 2 , Antonio Plata 3 , Pilar Martin Dávila 4 , Simona Iftimie 5 , Sergio Sequera 1 , Belén Loeches 6 , Luis Eduardo Lopez-Cortés 7 , Mari Carmen Fariñas 8 , Concepción Fernández-Roldan 1 , Rosario Javier-Martinez 1 , Patricia Muñoz 9 , Maria Del Mar Arenas-Miras 10 , Francisco Javier Martínez-Marcos 11 , Jose Maria Miró 12 , Carmen Herrero 13 , Elena Bereciartua 14 , Samantha E De Jesus 1 , Juan Pasquau 1
Affiliation  

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.

中文翻译:


达巴森队列:达巴万星作为革兰氏阳性球菌引起的心内膜炎和/或血流感染患者的巩固治疗。



目的 分析达巴万星 (DBV) 在临床实践中作为巩固治疗治疗革兰氏阳性球菌 (GPC) 引起的血流感染 (BSI) 和/或感染性心内膜炎 (IE) 的有效性,及其安全性和药物经济学影响。方法 对接受至少一剂 DBV 的 GPC 产生的 IE 和/或 BSI 住院患者进行了一项多中心、观察性和回顾性研究。在住院期间、3个月和1年评估临床反应。结果 83 名患者入组,中位年龄为 73 岁; 73.5%为男性; 59.04% 患有 BSI,49.04% 患有 IE(44.04% 为人工瓣膜 IE,32.4% 为天然 IE,23.5% 为起搏器引导)。最常见的微生物是 BSI 中的金黄色葡萄球菌 (49%) 和 IE 中的凝固酶阴性葡萄球菌 (44.1%)。所有IE患者均在医院临床治愈; 12 个月时,失访率为 2.9%,与 IE 无关的死亡率为 8.8%,治疗失败率为 2.9%。 DBV治疗IE的有效率为96.7%。 BSI的临床治愈率在住院期间和3个月时均为100%;随访期间无复发或死亡病例。没有患者因不良事件而停止治疗。 BSI 节省的住院时间为 636 天(315,424.20 欧元),IE 节省的住院时间为 557 天(283,187.45 欧元)。结论 对于临床稳定的 IE 和/或 BSI 患者,DBV 是一种有效的巩固抗生素疗法。由于该药物的药代动力学/药效学特征,事实证明这是一种具有成本效益的治疗方法,可以减少住院时间。
更新日期:2020-04-22
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