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门诊环境下单剂量奥利万星与标准护理静脉用抗生素治疗急性细菌性皮肤和皮肤结构感染的回顾性真实世界研究。

Single-Dose Oritavancin Compared to Standard of Care IV Antibiotics for Acute Bacterial Skin and Skin Structure Infection in the Outpatient Setting: A Retrospective Real-World Study.

作者信息

Anastasio Patrick J, Wolthoff Pete, Galli Annmarie, Fan Weihong

机构信息

Emerald Coast Infectious Disease Medical Group, 917 Mar Walt Drive, Fort Walton Beach, FL, 32547, USA.

Medical Data Analytics, 5 Sylvan Way, Parsippany, NJ, 07054, USA.

出版信息

Infect Dis Ther. 2017 Mar;6(1):115-128. doi: 10.1007/s40121-016-0145-7. Epub 2017 Jan 11.

Abstract

INTRODUCTION

Cost-containment strategies are shifting the treatment of acute bacterial skin and skin structure infections (ABSSSI) from inpatient to outpatient settings. Current standard of care (SoC) requires multiple-dose regimens, which are associated with high hospitalization rates and high costs. Oritavancin, a new single-dose antibiotic for ABSSSI, may be suitable for outpatient therapy. This analysis evaluates the effectiveness, costs, and resource utilization of oritavancin vs. SoC in a real-world, outpatient setting.

METHODS

A single-site, retrospective chart review was conducted of 118 adult patients diagnosed with ABSSSI and treated with either single-dose oritavancin or multi-dose SoC therapy between 6 August 2014 and 30 June 2015. Patients were assigned to two matched cohorts: oritavancin and SoC. Primary clinical effectiveness endpoints was the success (cured or improved) at 5-30 days after the course of antibiotic therapy has been completed. Secondary economic endpoints were total costs and healthcare resource utilization.

RESULTS

Oritavancin showed comparable clinical effectiveness vs. multi-dose SoC in the outpatient setting. A similar percentage of patients in the oritavancin (90.2%) and SoC cohorts (77.4%) achieved successful outcomes ("cure" or "improved"), with the cure rate higher for oritavancin (73.2%) vs. SoC (48.4%; P = 0.0315). Oritavancin's clinical effectiveness was consistent across patient subgroups with varying demographic, clinical, and ABSSSI characteristics. Oritavancin was consistently associated with lower costs (per-patient savings $2319) and reduced resource utilization measures, and it required just 1.0 day of therapy vs. 7.2 days for SoC.

CONCLUSION

Oritavancin is well suited for the outpatient treatment of ABSSSI. Compared with SoC, oritavancin offers comparable effectiveness, is more economical, and requires fewer healthcare resources.

摘要

引言

成本控制策略正在将急性细菌性皮肤和皮肤结构感染(ABSSSI)的治疗从住院环境转向门诊环境。当前的护理标准(SoC)需要多剂量方案,这与高住院率和高成本相关。奥利万星是一种用于治疗ABSSSI的新型单剂量抗生素,可能适用于门诊治疗。本分析评估了在真实世界的门诊环境中,奥利万星与SoC相比的有效性、成本和资源利用情况。

方法

对2014年8月6日至2015年6月30日期间118例诊断为ABSSSI并接受单剂量奥利万星或多剂量SoC治疗的成年患者进行了单中心回顾性病历审查。患者被分为两个匹配队列:奥利万星组和SoC组。主要临床有效性终点是抗生素治疗疗程结束后5至30天的成功(治愈或改善)情况。次要经济终点是总成本和医疗资源利用情况。

结果

在门诊环境中,奥利万星显示出与多剂量SoC相当的临床有效性。奥利万星组(90.2%)和SoC组(77.4%)中达到成功结局(“治愈”或“改善”)的患者比例相似,奥利万星的治愈率(73.2%)高于SoC组(48.4%;P = 0.0315)。奥利万星的临床有效性在不同人口统计学、临床和ABSSSI特征的患者亚组中是一致的。奥利万星始终与较低的成本(每位患者节省2319美元)和减少的资源利用措施相关,并且它仅需要1.0天的治疗,而SoC需要7.2天。

结论

奥利万星非常适合ABSSSI的门诊治疗。与SoC相比,奥利万星具有相当的有效性,更经济,并且需要的医疗资源更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/5336420/60d149d98116/40121_2016_145_Fig1_HTML.jpg

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