Annals of Clinical Microbiology and Antimicrobials (Oct 2019)

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

  • Carmen Hidalgo-Tenorio,
  • David Vinuesa,
  • Antonio Plata,
  • Pilar Martin Dávila,
  • Simona Iftimie,
  • Sergio Sequera,
  • Belén Loeches,
  • Luis Eduardo Lopez-Cortés,
  • Mari Carmen Fariñas,
  • Concepción Fernández-Roldan,
  • Rosario Javier-Martinez,
  • Patricia Muñoz,
  • Maria del Mar Arenas-Miras,
  • Francisco Javier Martínez-Marcos,
  • Jose Maria Miró,
  • Carmen Herrero,
  • Elena Bereciartua,
  • Samantha E. De Jesus,
  • Juan Pasquau

DOI
https://doi.org/10.1186/s12941-019-0329-6
Journal volume & issue
Vol. 18, no. 1
pp. 1 – 10

Abstract

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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.

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