Abstract：
OBJECTIVE: Persons who inject drugs (PWID) are at risk for severe gram-positive infections and may require prolonged hospitalization and intravenous (IV) antibiotic therapy. Dalbavancin (DBV) is a long-acting lipoglycopeptide that may reduce costs and provide effective treatment in this population.
METHODS: This was a retrospective review of PWID with severe gram-positive infections. Patients admitted from January 1, 2017, to November 1, 2019 (standard-of-care [SOC] group) and from November 15, 2019, to March 31, 2022 (DBV group) were included. The primary outcome was the total cost to the healthcare system. Secondary outcomes included hospital days saved and treatment failure.
RESULTS: A total of 87 patients were included (37 in the DBV group and 50 in the SOC group). Patients were a median of 34 years old and were predominantly Caucasian (82%). Staphylococcus aureus (82%) was the most common organism, and bacteremia (71%) was the most common type of infection. Compared to the SOC group, the DBV group would have had a median of 14 additional days of hospitalization if they had stayed to complete their therapy (P = 0.014). The median total cost to the healthcare system was significantly lower in the DBV group than in the SOC group ($31,698.00 vs $45,093.50; P = 0.035). The rate of treatment failure was similar between the groups (32.4% in the DBV group vs 36% in the SOC group; P = 0.729).
CONCLUSIONS: DBV is a cost-saving alternative to SOC IV antibiotics for severe gram-positive infections in PWID, with similar treatment outcomes. Larger prospective studies, including other patient populations, may demonstrate additional benefit.
METHODS: This was a retrospective review of PWID with severe gram-positive infections. Patients admitted from January 1, 2017, to November 1, 2019 (standard-of-care [SOC] group) and from November 15, 2019, to March 31, 2022 (DBV group) were included. The primary outcome was the total cost to the healthcare system. Secondary outcomes included hospital days saved and treatment failure.
RESULTS: A total of 87 patients were included (37 in the DBV group and 50 in the SOC group). Patients were a median of 34 years old and were predominantly Caucasian (82%). Staphylococcus aureus (82%) was the most common organism, and bacteremia (71%) was the most common type of infection. Compared to the SOC group, the DBV group would have had a median of 14 additional days of hospitalization if they had stayed to complete their therapy (P = 0.014). The median total cost to the healthcare system was significantly lower in the DBV group than in the SOC group ($31,698.00 vs $45,093.50; P = 0.035). The rate of treatment failure was similar between the groups (32.4% in the DBV group vs 36% in the SOC group; P = 0.729).
CONCLUSIONS: DBV is a cost-saving alternative to SOC IV antibiotics for severe gram-positive infections in PWID, with similar treatment outcomes. Larger prospective studies, including other patient populations, may demonstrate additional benefit.
摘要：
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目的：注射药物（PWID）的人有严重革兰阳性感染的风险，可能需要长期住院和静脉（IV）抗生素治疗。Dalbavancin（DBV）是一种长效脂糖肽，可以降低成本并在该人群中提供有效的治疗。
方法：这是一项对PWID合并严重革兰阳性感染的回顾性研究。纳入2017年1月1日至2019年11月1日（标准护理[SOC]组）和2019年11月15日至2022年3月31日（DBV组）收治的患者。主要结果是医疗保健系统的总成本。次要结果包括住院天数和治疗失败。
结果：共纳入87例患者（DBV组37例，SOC组50例）。患者年龄中位数为34岁，主要为白种人（82%）。金黄色葡萄球菌（82%）是最常见的细菌，菌血症（71%）是最常见的感染类型。与SOC组相比，如果DBV组坚持完成治疗,他们的中位住院天数为14天(P=0.014).DBV组医疗保健系统的总费用中位数明显低于SOC组（31,698.00美元vs45,093.50美元；P=0.035）。两组之间的治疗失败率相似（DBV组为32.4％，SOC组为36％；P=0.729）。
结论：对于PWID中的严重革兰氏阳性感染，DBV是SOCIV抗生素的一种节省成本的替代品，具有相似的治疗结果。更大的前瞻性研究，包括其他患者群体，可能会显示额外的好处。
目的：注射药物（PWID）的人有严重革兰阳性感染的风险，可能需要长期住院和静脉（IV）抗生素治疗。Dalbavancin（DBV）是一种长效脂糖肽，可以降低成本并在该人群中提供有效的治疗。
方法：这是一项对PWID合并严重革兰阳性感染的回顾性研究。纳入2017年1月1日至2019年11月1日（标准护理[SOC]组）和2019年11月15日至2022年3月31日（DBV组）收治的患者。主要结果是医疗保健系统的总成本。次要结果包括住院天数和治疗失败。
结果：共纳入87例患者（DBV组37例，SOC组50例）。患者年龄中位数为34岁，主要为白种人（82%）。金黄色葡萄球菌（82%）是最常见的细菌，菌血症（71%）是最常见的感染类型。与SOC组相比，如果DBV组坚持完成治疗,他们的中位住院天数为14天(P=0.014).DBV组医疗保健系统的总费用中位数明显低于SOC组（31,698.00美元vs45,093.50美元；P=0.035）。两组之间的治疗失败率相似（DBV组为32.4％，SOC组为36％；P=0.729）。
结论：对于PWID中的严重革兰氏阳性感染，DBV是SOCIV抗生素的一种节省成本的替代品，具有相似的治疗结果。更大的前瞻性研究，包括其他患者群体，可能会显示额外的好处。
