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EN-DALBACEN 2.0 Cohort: real-life study of dalbavancin as sequential/consolidation therapy in patients with infective endocarditis due to Gram-positive cocci

Abstract: Objectives Infective endocarditis (IE) has high mortality and morbidity and requires long hospital stays to 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.

 Fuente: International Journal of Antimicrobial Agents, 2023, 62(3), 106918

Editorial: Elsevier

 Año de publicación: 2023

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ijantimicag.2023.106918

ISSN: 0924-8579,1872-7913

Url de la publicación: https://doi.org/10.1016/j.ijantimicag.2023.106918

Autoría

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

PASQUAU, J.