Publication: EN-DALBACEN 2.0 Cohort: real-life study of dalbavancin as sequential/consolidation therapy in patients with infective
endocarditis due to Gram-positive cocci
Authors
Hidalgo-Tenorio, Carmen ; Sadyrbaeva-Dolgova, Svetlana ; Enríquez-Gómez, Andrés ; Muñoz, Patricia ; Plata-Ciezar, Antonio ; Miró, Jose Maria ; Alarcón, Arístides ; Martínez-Marcos, Francisco Javier ; Loeches, Belén ; Escrihuela-Vidal, Francesc ; Vinuesa, David ; Herrero, Carmen ; Boix-Palop, Lucia ; Arenas, María del Mar ; García-Vázquez, Elisa ; Arnaiz de las Revillas, Francisco ; Pasquau, J. ; EN-DALBACEN study group
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Publisher
Elsevier
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DOI
https://doi.org/10.1016/j.ijantimicag.2023.106918
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info:eu-repo/semantics/article
Description
©2023 The Author(s). This manuscript version is an open access article made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. This document is the Accepted, version of a Published Work that appeared in final form in International Journal of Antimicrobial Agents . To access the final edited and published work see https://doi.org/ 10.1016/j.ijantimicag.2023.106918
Abstract
Objectives: Infective endocarditis (IE) has high mortality and morbidity and requires long hospital staysto deliver the antibiotic treatment recommended in clinical practice guidelines. We aimed to analyse the health outcomes of the use of dalbavancin (DBV) in the consolidation treatment of IEs caused by Gram-positive cocci and to perform a pharmacoeconomic study.
Materials and methods: This observational, retrospective, Spanish multicentre study in patients with IE who received DBV as part of antibiotic treatment in consolidation phase were followed for at least 12 months. The study was approved by the Provincial Committee of the coordinating centre.
Results: The study included 124 subjects, 70.2% male, with a mean age of 67.4 years and median Charlson index of 4 (interquartile range: 2.5–6). Criteria for definite IE were met by 91.1%. Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (22.6%), Enterococcus faecalis (19.4%), and Streptococcus Spp. (9.7%) were isolated more frequently, all susceptible to vancomycin. Before DVB administration, 91.2% had undergone surgery; 60.5% had received a second regimen for 24.5 d (16.6–56); and 20.2% had received a third regimen for 14.5 d (12–19.5). DBV was administered to facilitate discharge in 95.2% of cases. At 12 months, the effectiveness was of 95.9%, and there was 0.8% loss to follow-up, 0.8% IE-related death, and 3.2% relapse. Adverse events were recorded in 3.2%. The hospital stay was reduced by 14 d, and there was a mean savings of 5548.57 €/patient vs. conventional treatments.
Conclusion: DBV is highly effective, safe, and cost-effective as consolidation therapy in patients with IE by Gram-positive cocci, with few adverse events.
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Citation
International Journal of Antimicrobial Agents 62 (2023) 106918
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