Department of Pharmacy, DeTar Healthcare System, Victoria, Texas, United States of America.
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas, United States of America.
PLoS One. 2021 Mar 18;16(3):e0248129. doi: 10.1371/journal.pone.0248129. eCollection 2021.
Oritavancin is a lipoglycopeptide antibiotic with in vitro bactericidal activity against gram-positive pathogens indicated for use in adults with acute bacterial skin and skin structure infections (ABSSSI). Its concentration-dependent activity and prolonged half-life provide a convenient single-dose alternative to multi-dose daily therapies for ABSSSI. This retrospective cohort study was conducted to quantify the clinical and economic advantages of using oritavancin compared to other antibiotic agents that have been historically effective for ABSSSI.
Seventy-nine patients received oritavancin who had failed previous outpatient antibiotic therapy (OPAT) for cellulitis or abscess and were subsequently readmitted to the hospital as an inpatient between 2016 and 2018. These patients were compared to a cohort of 28 patients receiving other antibiotics following OPAT failure and subsequent hospitalization for these two infection types. The primary clinical end point was average length of stay (aLOS) and secondary endpoints included readmission rates for the same indication at 30 and 90 days after discharge and the average hospital cost (aHC).
A total of 107 patients were hospitalized for treatment of cellulitis or abscess. Demographic characteristics of both the oritavancin and comparator groups were similar except for the presence of diabetes. The primary clinical endpoint showed a non-significant decrease in aLOS between the oritavancin group versus comparator (2.12 days versus 2.59 days; p = 0.097). The secondary endpoints revealed lower readmission rates associated with oritavancin treatment at 30 and 90 days; the average hospital cost was 5.9% lower for patients that received oritavancin.
The results of this study demonstrate that oritavancin provides not only a single-dose alternative to multi-day therapies for skin and skin structure infections, but also a clinical and economic advantage compared to other antibiotic agents.
奥他万星是一种具有体外杀菌活性的糖肽类抗生素，适用于治疗成人急性细菌性皮肤和皮肤结构感染（ABSSSI）。其浓度依赖性活性和延长的半衰期为 ABSSSI 提供了一种方便的单剂量替代多日每日治疗的选择。这项回顾性队列研究旨在量化与历史上对 ABSSSI 有效的其他抗生素相比，使用奥他万星的临床和经济优势。
2016 年至 2018 年间，79 名因蜂窝织炎或脓肿而在前瞻性门诊抗生素治疗（OPAT）失败后随后住院的患者接受了奥他万星治疗。将这些患者与 28 名因 OPAT 失败后因这两种感染类型住院而接受其他抗生素治疗的患者进行比较。主要临床终点为平均住院时间（aLOS），次要终点包括出院后 30 天和 90 天相同指征的再入院率和平均住院费用（aHC）。
共有 107 名患者因治疗蜂窝织炎或脓肿而住院。除糖尿病的存在外，奥他万星组和对照组的人口统计学特征相似。主要临床终点显示，奥他万星组与对照组的 aLOS 无显著差异（2.12 天与 2.59 天；p = 0.097）。次要终点显示，奥他万星治疗的 30 天和 90 天再入院率较低；接受奥他万星治疗的患者的平均住院费用降低了 5.9%。
这项研究的结果表明，奥他万星不仅为皮肤和皮肤结构感染提供了一种替代多日治疗的单剂量方案，而且与其他抗生素相比具有临床和经济优势。
