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新冠肺炎疫情期间的达巴万星

Dalbavancin During the COVID-19 Pandemic.

作者信息

Caputo Wayne J, Johnson Edward S, Fahoury George, Monterosa Patricia

机构信息

Clara Maass Medical Center, Wound Care Center, Belleville, NJ.

NY College of Podiatric Medicine and Mt. Sinai Hospital, NY.

出版信息

Surg Technol Int. 2022 Nov 15;41:52-55. doi: 10.52198/22.STI.41.WH1588.

Abstract

The COVID-19 pandemic, which started in March of 2020, and its associated surges have had an immense impact on the ability of medical staff to perform their daily activities. Thus, we sought to direct patients who had gram-positive Acute Bacterial Skin and Skin Structure Infections (ABSSSI) to our Outpatient Department/Wound Care Center for treatment. We met the challenge of the pandemic by shifting care in the treatment of ABSSSI using a new antibiotic delivery system. We examined the use and cost-effectiveness of Dalbavancin, a unique long-acting lipoglycopeptide antibiotic that is used in the treatment of acute bacterial skin and skin structure infections, during the COVID-19 pandemic. A total of 631 patients were treated in the Outpatient Department/Wound Care Center, with re-evaluation at the Wound Care Center on Day 3 post-infusion. The primary test of cure or major improvement was based on a 4- to 6-week re-assessment by the Wound Care Center Faculty (i.e., Podiatric, Vascular, Plastics, and Infectious Diseases). Treatment effectiveness was determined by examining documentation at follow-up. We also looked at the number of Outpatient Department treatments at the Wound Care Center for the periods 2018-2019 and 2020-2021. The shift of patients from the Emergency Department/Inpatient Department to the Outpatient Department/Wound Care Center was made possible by the use of the novel, streamlined, safe, Food and Drug Administration (FDA)-approved, well-tolerated antibiotic Dalbavancin. Dalbavancin is not prescribed for gram-negative infections, or for random prescribing, contamination, colonization, or prophylaxis. Dalbavancin has a low infusion reaction, low toxicity, long half-life, and low incidence of adverse reactions. Use of this medication was helpful for decreasing the inpatient burden in our facility.

摘要

始于2020年3月的新冠疫情及其相关的疫情高峰对医护人员开展日常工作的能力产生了巨大影响。因此,我们试图将患有革兰氏阳性急性细菌性皮肤和皮肤结构感染(ABSSSI)的患者引导至我们的门诊部/伤口护理中心进行治疗。我们通过使用一种新的抗生素给药系统来转移ABSSSI治疗中的护理,从而应对了疫情带来的挑战。我们研究了在新冠疫情期间,达巴万星(一种用于治疗急性细菌性皮肤和皮肤结构感染的独特长效脂糖肽抗生素)的使用情况及其成本效益。共有631名患者在门诊部/伤口护理中心接受治疗,并在输液后第3天在伤口护理中心进行重新评估。治愈或显著改善的主要检测基于伤口护理中心教员(即足病科、血管科、整形科和传染病科)在4至6周后的重新评估。通过检查随访记录来确定治疗效果。我们还查看了2018 - 2019年和2020 - 2021年期间伤口护理中心的门诊治疗次数。通过使用新型、简化、安全、经美国食品药品监督管理局(FDA)批准且耐受性良好的抗生素达巴万星,实现了患者从急诊科/住院部向门诊部/伤口护理中心的转移。达巴万星不用于革兰氏阴性感染,也不用于随意开药、污染、定植或预防。达巴万星具有低输液反应、低毒性、长半衰期和低不良反应发生率。使用这种药物有助于减轻我们机构的住院负担。

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