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Abstract：
BACKGROUND: Admissions for acute bacterial skin and skin structure infections (ABSSSI) are often prolonged because of intravenous (IV) antibiotics. Use of a long-acting IV antibiotic may reduce length of stay (LOS) on a hospitalist service. The ENHANCE ABSSSI trial sought to determine the impact on LOS and work productivity in patients treated with a long-acting IV antibiotic, dalbavancin, vs. usual care at an urban tertiary-care center.
METHODS: A single-center, pre- vs. post-period pragmatic trial at Weill-Cornell Medical Center assessed usual care for consecutively enrolled admitted ABSSSI patients during an observational period (pre-period). Identification and treatment of eligible admitted ABSSSI patients with dalbavancin were implemented in the post-period. Those with life-threatening infections, requiring multiple antibiotics/intensive care, or with unstable comorbidities were excluded. Outcomes were assessed over a 44-day follow-up period.
RESULTS: Of 48 and 43 patients enrolled, respectively, in the pre- and post-periods, mean infection-related LOS was reduced in the post-period (3.2 days vs. 4.8 days; P = 0.003). Similar results were found in an adjusted LOS analysis. Work productivity and activity impairment outcomes significantly improved in the post-period (P ≤ 0.01). Complete response rates were similar: 50% (pre-period) and 57% (post-period). Among AEs identified, 17% (n = 7) were found to have possible causal relation to dalbavancin in the post-period. Few AEs were serious (n = 3; 7% post-period versus n = 1; 2% pre-period).
CONCLUSIONS: After implementing the ENHANCE ABSSSI pathway, LOS was significantly reduced by almost 2 days, with potential improvements in work productivity and ability to complete daily activities.
BACKGROUND: ClinicalTrials.gov identifier, NCT03233438.
BACKGROUND: Allergan plc.
METHODS: A single-center, pre- vs. post-period pragmatic trial at Weill-Cornell Medical Center assessed usual care for consecutively enrolled admitted ABSSSI patients during an observational period (pre-period). Identification and treatment of eligible admitted ABSSSI patients with dalbavancin were implemented in the post-period. Those with life-threatening infections, requiring multiple antibiotics/intensive care, or with unstable comorbidities were excluded. Outcomes were assessed over a 44-day follow-up period.
RESULTS: Of 48 and 43 patients enrolled, respectively, in the pre- and post-periods, mean infection-related LOS was reduced in the post-period (3.2 days vs. 4.8 days; P = 0.003). Similar results were found in an adjusted LOS analysis. Work productivity and activity impairment outcomes significantly improved in the post-period (P ≤ 0.01). Complete response rates were similar: 50% (pre-period) and 57% (post-period). Among AEs identified, 17% (n = 7) were found to have possible causal relation to dalbavancin in the post-period. Few AEs were serious (n = 3; 7% post-period versus n = 1; 2% pre-period).
CONCLUSIONS: After implementing the ENHANCE ABSSSI pathway, LOS was significantly reduced by almost 2 days, with potential improvements in work productivity and ability to complete daily activities.
BACKGROUND: ClinicalTrials.gov identifier, NCT03233438.
BACKGROUND: Allergan plc.
摘要：
背景：急性细菌性皮肤和皮肤结构感染（ABSSSI）的入院时间通常因静脉注射（IV）抗生素而延长。使用长效IV抗生素可能会减少住院时间（LOS）。ENHANCEABSSSI试验旨在确定使用长效IV抗生素治疗的患者对LOS和工作效率的影响，dalbavancin,vs.城市三级护理中心的常规护理。
方法：单中心，前vs.Weill-Cornell医学中心的期后务实试验评估了观察期间(期前)连续纳入的ABSSSI入院患者的常规治疗.在术后阶段，对符合条件的入院ABSSSI患者进行了达巴万星的鉴定和治疗。那些感染危及生命的人，需要多种抗生素/重症监护,或不稳定的合并症被排除。在44天的随访期内评估结果。
结果：在48和43名患者中，分别,在前期和后期，术后平均感染相关LOS降低(3.2天vs.4.8天；P=0.003）。在调整后的LOS分析中发现了类似的结果。工作生产率和活动障碍结果在后期显着改善（P≤0.01）。完全缓解率相似:50%(期前)和57%(期后)。在确定的AE中，在后期发现17％（n=7）与达巴万宁可能有因果关系。很少有严重的AE(n=3；7%的期后对n=1；2%的期前)。
结论：实施ENHANCEABSSSI途径后，LOS显著减少了近2天，提高工作效率和完成日常活动的能力。
背景：ClinicalTrials.gov标识符，NCT03233438。
背景：Allerganplc.
方法：单中心，前vs.Weill-Cornell医学中心的期后务实试验评估了观察期间(期前)连续纳入的ABSSSI入院患者的常规治疗.在术后阶段，对符合条件的入院ABSSSI患者进行了达巴万星的鉴定和治疗。那些感染危及生命的人，需要多种抗生素/重症监护,或不稳定的合并症被排除。在44天的随访期内评估结果。
结果：在48和43名患者中，分别,在前期和后期，术后平均感染相关LOS降低(3.2天vs.4.8天；P=0.003）。在调整后的LOS分析中发现了类似的结果。工作生产率和活动障碍结果在后期显着改善（P≤0.01）。完全缓解率相似:50%(期前)和57%(期后)。在确定的AE中，在后期发现17％（n=7）与达巴万宁可能有因果关系。很少有严重的AE(n=3；7%的期后对n=1；2%的期前)。
结论：实施ENHANCEABSSSI途径后，LOS显著减少了近2天，提高工作效率和完成日常活动的能力。
背景：ClinicalTrials.gov标识符，NCT03233438。
背景：Allerganplc.
