{Reference Type}: Journal Article
{Title}: Dalbavancin as sequential therapy in infective endocarditis: Real-life experience in elder and comorbid patients.
{Author}: Aparicio-Minguijón E;Boán J;Terrón A;Heredia C;Puente C;Pérez-Jacoiste Asín A;Orellana MÁ;Domínguez L;Caro JM;López-Gude MJ;Aguilar-Blanco EM;Eixerés-Esteve A;López-Medrano F;
{Journal}: Enferm Infecc Microbiol Clin (Engl Ed)
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 19
暂无{DOI}: 10.1016/j.eimce.2024.04.012
{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.