DALBACEN cohort: dalbavancin as consolidation therapy in patients with endocarditis and/or bloodstream infection produced by gram-positive cocci

[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 multicent...

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Detalles Bibliográficos
Autores: Hidalgo-Tenorio, Carmen, Vinuesa García, David, Plata-Ciezar, Antonio, Martín-Dávila, Pilar, Iftimie, Simona, Sequera, Sergio, Loeches, Belén, López-Cortés, Luis Eduardo, Fariñas, María del Carmen, Fernández-Roldán, Concepción, Javier-Martinez, Rosario, Muñoz García, Patricia, Arenas-Miras, Maria del Mar, Martínez-Marcos, Francisco Javier, Miró, José María, Herrero-Rodríguez, Carmen, Bereciartúa, Elena, De Jesus, Samantha E., Pasquau-Liaño, Juan
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/212324
Acceso en línea:http://hdl.handle.net/10261/212324
Access Level:acceso abierto
Palabra clave:Endocarditis
Bloodstream infections
Dalbavancin
Descripción
Sumario:[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.

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