Segala Daniela, Barbieri Marco, Di Nuzzo Mariachiara, Benazzi Melissa, Bonazza Aurora, Romanini Letizia, Quarta Brunella, Scolz Kristian, Marra Anna, Campioni Diana, Cultrera Rosario
Infectious Diseases Unit, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara - Italy.
Department of Traslational Medicine, University of Ferrara, Ferrara - Italy.
Glob Reg Health Technol Assess. 2024 Jul 29;11(Suppl 2):5-12. doi: 10.33393/grhta.2024.3094. eCollection 2024 Jan-Dec.
The therapeutic approach to the patient with acute bacterial skin and skin structure infection (ABSSSI) and complicated infections often involves the early transition from intravenous to oral therapy (early switch) or early discharge. Our study aimed to evaluate sustainable and innovative care models that can be transferred to community healthcare and the economic impact of dalbavancin therapy vs Standard of Care (SoC) therapy for the treatment of ABSSSI and other Gram-positive infections including those by multidrug-resistant organisms. We also described the organization of an infectious disease network that allows optimizing the treatment of ABSSSI and other complex infections with dalbavancin.
We retrospectively studied all patients treated with dalbavancin in the University Hospital "S. Anna" of Ferrara, Italy, between November 2016 and December 2022. The clinical information of each patient was collected from the hospital's SAP database and used to evaluate the impact of dalbavancin in early discharge with reduction of length of stay promoting dehospitalization and in improving adherence to antibiotic therapy.
A total of 287 patients (165 males and 122 females) were included in the study of which 62 were treated with dalbavancin. In 13/62 patients dalbavancin was administered in a single dose at the completion of therapy to facilitate early discharge. Assuming a 12-day hospitalization required for the treatment of ABSSSI or to complete the treatment of osteomyelitis or spondilodiscitis, the treatment with dalbavancin results in a cost reduction of more than €3,200 per single patient compared to SoC (dancomycin, linezolid or vancomycin).
Dalbavancin has proven to be a valid therapeutic aid in the organization of a territorial infectious disease network given its prolonged action, which allows the dehospitalization with management of even patients with complex infections in outpatient parenteral antimicrobial therapy.
急性细菌性皮肤和皮肤结构感染（ABSSSI）及复杂感染患者的治疗方法通常涉及从静脉治疗尽早过渡到口服治疗（早期换药）或尽早出院。我们的研究旨在评估可转移至社区医疗保健的可持续创新护理模式，以及达巴万星治疗与标准治疗（SoC）治疗ABSSSI和其他革兰氏阳性感染（包括耐多药菌感染）的经济影响。我们还描述了一个传染病网络的组织情况，该网络可优化使用达巴万星治疗ABSSSI和其他复杂感染。
我们回顾性研究了2016年11月至2022年12月期间在意大利费拉拉大学医院“S. Anna”接受达巴万星治疗的所有患者。从医院的SAP数据库收集每位患者的临床信息，用于评估达巴万星在促进出院减少住院时间以及提高抗生素治疗依从性方面对早期出院的影响。
共有287名患者（165名男性和122名女性）纳入研究，其中62名接受了达巴万星治疗。在62名患者中的13名患者中，在治疗结束时给予单剂量达巴万星以促进早期出院。假设治疗ABSSSI或完成骨髓炎或脊椎间盘炎治疗需要住院治疗12天，与SoC（达托霉素、利奈唑胺或万古霉素）相比，使用达巴万星治疗可使每位患者的成本降低超过3200欧元。
鉴于达巴万星作用时间长，已被证明是构建地区传染病网络的有效治疗辅助手段，它能够让复杂感染患者在门诊接受胃肠外抗菌治疗时实现出院并得到管理。
