Abstract：
BACKGROUND: Oritavancin and dalbavancin are long-acting lipoglycopeptide antibiotics approved for the treatment of skin and skin structure infections. Recently, they have been used for outpatient antimicrobial therapy for complicated infections. No head-to-head studies exist for this purpose.
OBJECTIVE: To compare outcomes of patients treated with multiple doses of oritavancin or dalbavancin for complicated infections.
METHODS: This was a single-centre, retrospective cohort study evaluating adult patients who received two or more doses of lipoglycopeptides for complicated infections from February 2019 through December 2022. Patients receiving oritavancin were compared to dalbavancin after propensity score-matching. The primary endpoint was clinical success at 90 days. Other endpoints included: 30-day re-admission, 30-day mortality, adverse drug reactions (ADRs), and changes in white blood cell count and inflammatory markers after the first dose.
RESULTS: After exclusions and propensity score-matching, 131 matched pairs (N = 262) were included in the analysis. Most patients were receiving lipoglycopeptide therapy for osteomyelitis. There was no significant difference in clinical success at 90 days in patients who received oritavancin compared to those who received dalbavancin (99 [76%] vs. 103 [79%], respectively; P = 0.556). There was no significant difference in secondary endpoints, however, there was a trend towards higher incidence of ADRs oritavancin compared to dalbavancin (9 [7%] vs. 2 [2%], respectively; P = 0.060) which led to more treatment discontinuation.
CONCLUSIONS: There was no significant difference in efficacy between multi-dose oritavancin and dalbavancin for the treatment of complicated infections. Both agents were generally well tolerated; however, dalbavancin may be better tolerated when long-term treatment is warranted.
OBJECTIVE: To compare outcomes of patients treated with multiple doses of oritavancin or dalbavancin for complicated infections.
METHODS: This was a single-centre, retrospective cohort study evaluating adult patients who received two or more doses of lipoglycopeptides for complicated infections from February 2019 through December 2022. Patients receiving oritavancin were compared to dalbavancin after propensity score-matching. The primary endpoint was clinical success at 90 days. Other endpoints included: 30-day re-admission, 30-day mortality, adverse drug reactions (ADRs), and changes in white blood cell count and inflammatory markers after the first dose.
RESULTS: After exclusions and propensity score-matching, 131 matched pairs (N = 262) were included in the analysis. Most patients were receiving lipoglycopeptide therapy for osteomyelitis. There was no significant difference in clinical success at 90 days in patients who received oritavancin compared to those who received dalbavancin (99 [76%] vs. 103 [79%], respectively; P = 0.556). There was no significant difference in secondary endpoints, however, there was a trend towards higher incidence of ADRs oritavancin compared to dalbavancin (9 [7%] vs. 2 [2%], respectively; P = 0.060) which led to more treatment discontinuation.
CONCLUSIONS: There was no significant difference in efficacy between multi-dose oritavancin and dalbavancin for the treatment of complicated infections. Both agents were generally well tolerated; however, dalbavancin may be better tolerated when long-term treatment is warranted.
摘要：
背景：奥利万星和达巴万星是被批准用于治疗皮肤和皮肤结构感染的长效脂糖肽抗生素。最近,它们已被用于复杂感染的门诊抗菌治疗。没有为此目的的头对头研究。
目的：比较多剂量奥利万星或达巴万星治疗复杂感染的患者的预后。
方法：这是一个单中心，回顾性队列研究评估了2019年2月至2022年12月期间接受2次或更多剂量脂糖肽治疗的复杂感染的成年患者.在倾向评分匹配后，将接受oritavancin的患者与dalbavancin进行比较。主要终点是90天的临床成功。其他终点包括：30天重新入院，30天死亡率，药物不良反应（ADR），首次给药后白细胞计数和炎症标志物的变化。
结果：排除和倾向得分匹配后，分析中包括131对匹配的对(N=262)。大多数患者正在接受脂糖肽治疗骨髓炎。与接受达巴万星的患者相比，接受奥利万星的患者在90天时的临床成功率没有显着差异（99[76％]vs103[79％]，分别为；p=0.556)。次要终点没有显着差异，然而,与达巴万辛相比，奥利万辛的ADRs发病率有较高的趋势(9[7%]vs2[2%]，分别；p=0.060），这导致更多的治疗中断。
结论：多剂量奥利万星和达巴万星治疗复杂感染的疗效无显著差异。两种药物的耐受性普遍良好；然而，当需要长期治疗时,达巴万星的耐受性可能更好.
目的：比较多剂量奥利万星或达巴万星治疗复杂感染的患者的预后。
方法：这是一个单中心，回顾性队列研究评估了2019年2月至2022年12月期间接受2次或更多剂量脂糖肽治疗的复杂感染的成年患者.在倾向评分匹配后，将接受oritavancin的患者与dalbavancin进行比较。主要终点是90天的临床成功。其他终点包括：30天重新入院，30天死亡率，药物不良反应（ADR），首次给药后白细胞计数和炎症标志物的变化。
结果：排除和倾向得分匹配后，分析中包括131对匹配的对(N=262)。大多数患者正在接受脂糖肽治疗骨髓炎。与接受达巴万星的患者相比，接受奥利万星的患者在90天时的临床成功率没有显着差异（99[76％]vs103[79％]，分别为；p=0.556)。次要终点没有显着差异，然而,与达巴万辛相比，奥利万辛的ADRs发病率有较高的趋势(9[7%]vs2[2%]，分别；p=0.060），这导致更多的治疗中断。
结论：多剂量奥利万星和达巴万星治疗复杂感染的疗效无显著差异。两种药物的耐受性普遍良好；然而，当需要长期治疗时,达巴万星的耐受性可能更好.
