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Title

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

AuthorsHidalgo-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-Roldan, Concepción; Javier-Martinez, Rosario; Muñoz García, Patricia; Arenas-Miras, Maria del Mar; Martínez-Marcos, Francisco Javier; Miró, José María; Herrero, Carmen ; Bereciartúa, Elena; De Jesus, Samantha E.; Pasquau-Liaño, Juan
KeywordsEndocarditis
Bloodstream infection
Dalbavancin
Issue Date2019
PublisherBioMed Central
CitationAnnals of Clinical Microbiology and Antimicrobials 18: 30 (2019)
Abstract[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.
Publisher version (URL)https://doi.org/10.1186/s12941-019-0329-6
URIhttp://hdl.handle.net/10261/212324
Identifiersdoi: 10.1186/s12941-019-0329-6
e-issn: 1476-0711
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