Wilson Samuel E, Graham Donald R, Wang Whedy, Bruss Jon B, Castaneda-Ruiz Bibiana
University of California, Irvine, CA, USA.
Springfield Clinic, Springfield, IL, USA.
Infect Dis Ther. 2017 Sep;6(3):413-422. doi: 10.1007/s40121-017-0162-1. Epub 2017 Jul 10.
Concurrent Staphylococcus aureus bacteremia (SAB) worsens outcomes and increases mortality in patients with complicated skin and skin structure infections (cSSSI), hospital-acquired bacterial pneumonia, and ventilator-associated bacterial pneumonia (HABP/VABP). These challenges highlight the need for alternative treatments. Telavancin (TLV), a bactericidal lipoglycopeptide with high in vitro potency, effectively treats patients with cSSSI and HABP/VABP caused by Gram-positive pathogens, particularly S. aureus.
This retrospective analysis evaluated patients from the Assessment of Telavancin in Complicated Skin and Skin Structure Infections and Assessment of Telavancin for Treatment of Hospital-Acquired Pneumonia studies with baseline, concurrent SAB. Differences in the clinical cure rates at test-of-cure and safety outcomes were compared for TLV vs vancomycin (VAN) treatment groups.
A total of 105 patients, 32 cSSSI and 73 HABP/VABP, had baseline, concurrent SAB. The clinical cure rates for all-treated SAB patients in the cSSSI (TLV 57.1% and VAN 54.5%) and HABP/VABP (TLV 54.3% and VAN 47.2%) groups were comparable. For both types of infections, the safety profile of TLV and VAN showed similar incidences of adverse events (AEs), serious AEs, or AEs leading to discontinuation. One VAN-treated patient died in the cSSSI group, and there were 13 deaths in each treatment arm of the HABP/VABP group.
This retrospective analysis demonstrated that TLV is clinically comparable in both efficacy and safety to VAN, and, therefore, may be an appropriate therapeutic option for the treatment of patients with HABP/VABP or cSSSI and concurrent SAB. Given the limited sample size in this subgroup, the interpretation of these results is limited.
Theravance Biopharma Antibiotics, Inc.
并发金黄色葡萄球菌菌血症(SAB)会使复杂性皮肤和皮肤结构感染(cSSSI)、医院获得性细菌性肺炎以及呼吸机相关性细菌性肺炎(HABP/VABP)患者的预后恶化并增加死亡率。这些挑战凸显了对替代治疗方法的需求。替拉万星(TLV)是一种具有高体外活性的杀菌性脂糖肽,可有效治疗由革兰氏阳性病原体,尤其是金黄色葡萄球菌引起的cSSSI和HABP/VABP患者。
这项回顾性分析评估了来自“替拉万星治疗复杂性皮肤和皮肤结构感染评估”以及“替拉万星治疗医院获得性肺炎评估”研究中伴有基线并发SAB的患者。比较了替拉万星与万古霉素(VAN)治疗组在治愈测试时的临床治愈率和安全性结果的差异。
共有105例患者,其中32例为cSSSI,73例为HABP/VABP,伴有基线并发SAB。cSSSI组(替拉万星为57.1%,万古霉素为54.5%)和HABP/VABP组(替拉万星为54.3%,万古霉素为47.2%)中所有接受治疗的SAB患者的临床治愈率相当。对于这两种类型的感染,替拉万星和万古霉素的安全性概况显示不良事件(AE)、严重AE或导致停药的AE发生率相似。cSSSI组中有1例接受万古霉素治疗的患者死亡,HABP/VABP组的每个治疗组中有13例死亡。
这项回顾性分析表明,替拉万星在疗效和安全性方面在临床上与万古霉素相当,因此,可能是治疗HABP/VABP或cSSSI并发SAB患者的合适治疗选择。鉴于该亚组的样本量有限,这些结果的解释受到限制。
Theravance Biopharma Antibiotics, Inc.