Abstract：
OBJECTIVE: This study aimed to evaluate the effectiveness of dalbavancin as sequential therapy in patients with infective endocarditis (IE) due to gram positive bacteria (GPB) in a real-life heterogenous cohort with comorbid patients.
METHODS: A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate.
RESULTS: The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2-85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4-9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was Staphylococcus aureus (26.3%) followed by Enterococcus faecalis (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20-34) and 14 days (IQR 14-28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with Enterococcus faecalis IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%).
CONCLUSIONS: This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.
METHODS: A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate.
RESULTS: The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2-85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4-9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was Staphylococcus aureus (26.3%) followed by Enterococcus faecalis (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20-34) and 14 days (IQR 14-28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with Enterococcus faecalis IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%).
CONCLUSIONS: This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.
摘要：
目的：本研究旨在评估达巴万星作为序贯疗法治疗因革兰氏阳性菌(GPB)引起的感染性心内膜炎(IE)患者的有效性，并纳入一个现实生活中的异类队列。
方法：制定了一项单中心回顾性队列研究，包括2017年1月至2022年2月期间所有接受达巴万星治疗的明确IE患者。进行了6个月的随访。主要结果是临床治愈率，临床和微生物复发，6个月死亡率，和不良反应（AE）率。
结果：该研究包括61次IE发作。中位年龄为78.5岁（四分位距[IQR]63.2-85.2），78.7%为男性,Charlson合并症指数中位数为7分（IQR4-9分）。总的来说,49.2%遭受原生瓣膜IE。最常见的微生物是金黄色葡萄球菌（26.3％），其次是粪肠球菌（21.3％）。初始抗菌治疗和达巴万星治疗的中位持续时间分别为27天（IQR20-34）和14天（IQR14-28）。住院总减少1090天。最常见的剂量是每14天1500mg达巴万星(96.7%)。在8.2％的患者中检测到AE，只有1例(1.6%)归因于达巴万金(输注反应).86.9%的患者实现了临床治愈。1例粪肠球菌IE患者(1.6%)复发。6个月死亡率为11.5%，只有1名与IE相关的死亡(1.6%)。
结论：这项研究表明，达巴万星在IE患者的异质性真实世界队列中具有很高的疗效，具有出色的安全性。Dalbavancin允许大幅减少住院时间。
方法：制定了一项单中心回顾性队列研究，包括2017年1月至2022年2月期间所有接受达巴万星治疗的明确IE患者。进行了6个月的随访。主要结果是临床治愈率，临床和微生物复发，6个月死亡率，和不良反应（AE）率。
结果：该研究包括61次IE发作。中位年龄为78.5岁（四分位距[IQR]63.2-85.2），78.7%为男性,Charlson合并症指数中位数为7分（IQR4-9分）。总的来说,49.2%遭受原生瓣膜IE。最常见的微生物是金黄色葡萄球菌（26.3％），其次是粪肠球菌（21.3％）。初始抗菌治疗和达巴万星治疗的中位持续时间分别为27天（IQR20-34）和14天（IQR14-28）。住院总减少1090天。最常见的剂量是每14天1500mg达巴万星(96.7%)。在8.2％的患者中检测到AE，只有1例(1.6%)归因于达巴万金(输注反应).86.9%的患者实现了临床治愈。1例粪肠球菌IE患者(1.6%)复发。6个月死亡率为11.5%，只有1名与IE相关的死亡(1.6%)。
结论：这项研究表明，达巴万星在IE患者的异质性真实世界队列中具有很高的疗效，具有出色的安全性。Dalbavancin允许大幅减少住院时间。
