Dataset Information

Comparison of Sequential Dalbavancin With Standard-of-Care Treatment for Staphylococcus aureus Bloodstream Infections.

ABSTRACT:

Background

Dalbavancin (DAL) is a long-acting lipoglycopeptide with activity against Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). This study investigates DAL as sequential therapy in S. aureus bloodstream infections (BSIs).

Methods

We conducted a retrospective cohort study from 2014 to 2021 comparing sequential DAL with standard-of-care therapy (SoC) for S. aureus BSI. The primary outcome was 90-day clinical failure (90-day all-cause mortality or 90-day recurrence). Secondary outcomes were incidence of acute kidney injury, creatinine phosphokinase elevations, catheter-related thrombosis, and hospital-acquired infections. Analyses were adjusted using inverse probability of treatment weighting (IPTW).

Results

Overall, 225 patients (45 DAL, 180 SoC) were included. DAL patients had a higher incidence of community-acquired infection and persons who use drugs; SoC patients had more comorbidities and a longer duration of bacteremia. MRSA incidence was similar between the DAL and SoC groups. The median length of stay was 16 days among DAL recipients compared with 24 days among SoC recipients. Central catheter placement was 17.8% compared with 57.2% in the SoC group. Ninety-day clinical failure occurred in 13.3% and 18.3% of participants in the DAL and SOC groups, respectively. In IPTW-adjusted analysis, sequential DAL was not associated with 90-day clinical failure (adjusted odds ratio, 0.94; 95% CI, 0.333-2.32).

Conclusions

This study provides preliminary evidence that select patients with S. aureus BSI treated with sequential DAL have similar clinical failure rates, with significant reductions in catheter placement and hospital length of stay compared with SoC. Further prospective evaluation is needed.

SUBMITTER: Molina KC

PROVIDER: S-EPMC9314917 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Comparison of Sequential Dalbavancin With Standard-of-Care Treatment for <i>Staphylococcus aureus</i> Bloodstream Infections.

Molina Kyle C KC Lunowa Cali C Lebin Madelyn M Segerstrom Nunez Andrea A Azimi Sara F SF Krsak Martin M Mueller Scott W SW Miller Matthew A MA

Open forum infectious diseases 20220714 7

<h4>Background</h4>Dalbavancin (DAL) is a long-acting lipoglycopeptide with activity against <i>Staphylococcus aureus,</i> including methicillin-resistant <i>S. aureus</i> (MRSA). This study investigates DAL as sequential therapy in <i>S. aureus</i> bloodstream infections (BSIs).<h4>Methods</h4>We conducted a retrospective cohort study from 2014 to 2021 comparing sequential DAL with standard-of-care therapy (SoC) for <i>S. aureus</i> BSI. The primary outcome was 90-day clinical failure (90-day a ...[more]

PMID: 35899276

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