ABSTRACT

Objectives

To know the efficacy of different doses of dalbavancin in acute bacterial skin and skin-structure infections (ABSSSIs) and versus other antibiotics.

Methods

We performed a systematic review of dalbavancin efficacy for ABSSSIs. We selected 10 clinical trials from MEDLINE and Cochrane databases for qualitative review. Of these, five trials compared one or two doses of dalbavancin versus other antibiotics such as vancomycin or linezolid.

Results

Treatment outcomes with other antibiotics were not significantly different versus two doses of dalbavancin (OR 1.13; 95% CI 0.75–1.71; p = 0.55) or single dose dalbavancin (OR 0.98; 95% CI 0.19–5.17; p = 0.98). One dose versus two doses of dalbavancin did not show significant differences in any of the treatment groups. In contrast, the global microbiological assessment results indicated a favorable outcome for two doses of dalbavancin compared to the single dose of dalbavancin (OR 2.96; 95% CI 1.19–7.39; p = 0.02) in both methicillin-resistant and methicillin-susceptible Staphylococcus aureus.

Conclusion

Either single dose or two dose dalbavancin treatment is as clinically effective as other antibiotics such as vancomycin and linezolid for the treatment of ABSSSIs.

Abbreviations ABSSI: acute bacterial skin and skin-structure infection; AUC: area under the concentration-time curve; CE: clinical evaluable; CI: confidence interval; EOT: end of treatment; ITT: intention-to-treat; LOS: length of stay; MIC: minimum inhibitory concentration; MIC₉₀: minimum concentration to inhibit growth of 90% of isolates; MR: methicillin resistant; MRSA: methicillin-resistant Staphylococcus aureus; MS: methicillin susceptible; MSSA: methicillin-susceptible Staphylococcus aureus; OPAT: Outpatient Parenteral Antimicrobial Therapy; OR: odds ratio; PI: penicillin intermediate; PR: penicillin resistant; PS penicillin susceptible; SIRS: systemic inflammatory response syndrome; SSTI: skin and soft tissue infection; TOC: test of cure; VR: vancomycin resistant; VS: vancomycin susceptible.

中文翻译：

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急性细菌性皮肤和皮肤结构感染，达巴万星的功效：系统评价和荟萃分析

摘要

目标

了解不同剂量的达巴万星在急性细菌性皮肤和皮肤结构感染 (ABSSSIs) 中的疗效，以及与其他抗生素的疗效对比。

方法

我们对达巴万星对 ABSSSI 的疗效进行了系统评价。我们从 MEDLINE 和 Cochrane 数据库中选择了 10 项临床试验进行定性审查。其中，五项试验将一剂或两剂达巴万星与万古霉素或利奈唑胺等其他抗生素进行了比较。

结果

与两剂达巴万星（OR 1.13；95% CI 0.75–1.71；p = 0.55）或单剂达巴万星（OR 0.98；95% CI 0.19–5.17；p = 0.98）相比，其他抗生素的治疗结果没有显着差异。一剂达巴万星与两剂达巴万星相比，在任何治疗组中均未显示出显着差异。相比之下，全球微生物学评估结果表明，与单剂量达巴万星相比，双剂量达巴万星对甲氧西林耐药和甲氧西林敏感金黄色葡萄球菌的结果有利（OR 2.96；95% CI 1.19–7.39；p = 0.02） .

结论

单剂量或双剂量达巴万星治疗在临床上与其他抗生素如万古霉素和利奈唑胺治疗 ABSSSI 一样有效。

缩写 ABSSI：急性细菌性皮肤和皮肤结构感染；AUC：浓度-时间曲线下面积；CE：临床可评价；CI：置信区间；EOT：治疗结束；ITT：意向治疗；LOS：停留时间；MIC：最低抑菌浓度；MIC ₉₀：抑制 90% 分离株生长的最低浓度；MR：耐甲氧西林；MRSA：耐甲氧西林金黄色葡萄球菌；MS：甲氧西林敏感；MSSA：甲氧西林敏感金黄色葡萄球菌；OPAT：门诊肠外抗菌治疗；OR：比值比；PI：青霉素中间体；PR：青霉素耐药；PS 青霉素敏感；SIRS：全身炎症反应综合征；SSTI：皮肤和软组织感染；TOC：固化试验；VR：万古霉素耐药；VS：对万古霉素敏感。