Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality

Dalbavancin is a new antibiotic that is effective against Gram-positive microorganisms, including methicillin-resistant <i>Staphylococci</i>, and offers the possibility of administering intravenous therapy once weekly in an ambulatory setting. We conducted a multicenter observational cas...

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Autores principales:	Mar de Pablo-Miró, Sergi Pujol-Ruiz, Simona Iftimie, María del Mar Arenas-Miras, Inmaculada López-Montesinos, Xavier Duran-Jordà, Albert Anglès, Santiago Grau, Juan P. Horcajada
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	dalbavancin hospital stay effectiveness mortality gram-positive multidrug-resistant gram-positive cocci Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/c400ff53f5ba40989472413ca7c1487f
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spelling	oai:doaj.org-article:c400ff53f5ba40989472413ca7c1487f2021-11-25T16:22:16ZComparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality10.3390/antibiotics101112962079-6382https://doaj.org/article/c400ff53f5ba40989472413ca7c1487f2021-10-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1296https://doaj.org/toc/2079-6382Dalbavancin is a new antibiotic that is effective against Gram-positive microorganisms, including methicillin-resistant <i>Staphylococci</i>, and offers the possibility of administering intravenous therapy once weekly in an ambulatory setting. We conducted a multicenter observational case-control study, comparing all patients who received dalbavancin (cases) with hospitalized patients who were treated instead with daptomycin, linezolid or vancomycin (controls), based on clinical diagnosis, main microorganism involved, and age. The primary outcome was the length of hospital stay after starting the study antimicrobial. Secondary outcomes were 7-day and 30-day efficacy, 30-day mortality, 90-day recurrence, 90-day and 6-month hospitalization, presence of adverse events and healthcare-associated infections; 161 patients (44 cases and 117 controls) were included. Bivariate analysis showed that dalbavancin reduced the total length of hospital stay (<i>p</i> < 0.001), with fewer 90-day recurrences (<i>p</i> = 0.005), 6-month hospitalizations related to the same infection (<i>p</i> = 0.004) and non-related hospitalizations (<i>p</i> = 0.035). Multivariate analyses showed that length of hospital stay was significantly shorter in patients treated with dalbavancin (−12.05 days 95% CI [−17.00, −7.11], <i>p</i> < 0.001), and 30-day efficacy was higher in the dalbavancin group (OR 2.62 95% CI [1.07, 6.37], <i>p</i> = 0.034). Although sample size of the study may be a limitation, we can conclude that Dalbavancin is a useful antimicrobial drug against Gram-positive infections, including multidrug-resistant pathogens, and allows for a remarkable reduction in length of hospital stay with greater 30-day efficacy.Mar de Pablo-MiróSergi Pujol-RuizSimona IftimieMaría del Mar Arenas-MirasInmaculada López-MontesinosXavier Duran-JordàAlbert AnglèsSantiago GrauJuan P. HorcajadaMDPI AGarticledalbavancinhospital stayeffectivenessmortalitygram-positivemultidrug-resistant gram-positive cocciTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1296, p 1296 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dalbavancin hospital stay effectiveness mortality gram-positive multidrug-resistant gram-positive cocci Therapeutics. Pharmacology RM1-950
spellingShingle	dalbavancin hospital stay effectiveness mortality gram-positive multidrug-resistant gram-positive cocci Therapeutics. Pharmacology RM1-950 Mar de Pablo-Miró Sergi Pujol-Ruiz Simona Iftimie María del Mar Arenas-Miras Inmaculada López-Montesinos Xavier Duran-Jordà Albert Anglès Santiago Grau Juan P. Horcajada Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
description	Dalbavancin is a new antibiotic that is effective against Gram-positive microorganisms, including methicillin-resistant <i>Staphylococci</i>, and offers the possibility of administering intravenous therapy once weekly in an ambulatory setting. We conducted a multicenter observational case-control study, comparing all patients who received dalbavancin (cases) with hospitalized patients who were treated instead with daptomycin, linezolid or vancomycin (controls), based on clinical diagnosis, main microorganism involved, and age. The primary outcome was the length of hospital stay after starting the study antimicrobial. Secondary outcomes were 7-day and 30-day efficacy, 30-day mortality, 90-day recurrence, 90-day and 6-month hospitalization, presence of adverse events and healthcare-associated infections; 161 patients (44 cases and 117 controls) were included. Bivariate analysis showed that dalbavancin reduced the total length of hospital stay (<i>p</i> < 0.001), with fewer 90-day recurrences (<i>p</i> = 0.005), 6-month hospitalizations related to the same infection (<i>p</i> = 0.004) and non-related hospitalizations (<i>p</i> = 0.035). Multivariate analyses showed that length of hospital stay was significantly shorter in patients treated with dalbavancin (−12.05 days 95% CI [−17.00, −7.11], <i>p</i> < 0.001), and 30-day efficacy was higher in the dalbavancin group (OR 2.62 95% CI [1.07, 6.37], <i>p</i> = 0.034). Although sample size of the study may be a limitation, we can conclude that Dalbavancin is a useful antimicrobial drug against Gram-positive infections, including multidrug-resistant pathogens, and allows for a remarkable reduction in length of hospital stay with greater 30-day efficacy.
format	article
author	Mar de Pablo-Miró Sergi Pujol-Ruiz Simona Iftimie María del Mar Arenas-Miras Inmaculada López-Montesinos Xavier Duran-Jordà Albert Anglès Santiago Grau Juan P. Horcajada
author_facet	Mar de Pablo-Miró Sergi Pujol-Ruiz Simona Iftimie María del Mar Arenas-Miras Inmaculada López-Montesinos Xavier Duran-Jordà Albert Anglès Santiago Grau Juan P. Horcajada
author_sort	Mar de Pablo-Miró
title	Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
title_short	Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
title_full	Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
title_fullStr	Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
title_full_unstemmed	Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality
title_sort	comparative analysis of dalbavancin versus other antimicrobial options for gram-positive cocci infections: effectiveness, hospital stay and mortality
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c400ff53f5ba40989472413ca7c1487f
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Comparative Analysis of Dalbavancin versus Other Antimicrobial Options for Gram-Positive Cocci Infections: Effectiveness, Hospital Stay and Mortality

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