Original Research
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Introduction: Oritavancin and dalbavancin are long-acting lipoglycopeptide antibiotics that have recently gained traction for weekly use in outpatient antimicrobial therapy (OPAT) for complicated infections. Currently, no head-to-head studies exist for this purpose.
Research Question or Hypothesis: Are there differences in clinical outcomes in patients receiving multiple doses of oritavancin or dalbavancin for complicated infections?
Study Design: Single-center, retrospective, propensity-matched cohort study
Methods: Adult patients receiving treatment with multiple doses of lipoglycopeptides for complicated infections from February 2019 through December 2022 were eligible for inclusion. Patients receiving oritavancin were compared to dalbavancin after propensity score matching based on baseline characteristics, hospital admission prior to therapy initiation, infection type, and lipoglycopeptide regimen characteristics. The primary endpoint was clinical success at 90 days. Additional endpoints assessed included: 30-day (re-)admission, 30-day mortality, frequency of adverse drug reactions (ADRs), and changes in white blood cells (WBC) and inflammatory markers.
Results: 700 encounters were initially screened. After exclusions and propensity score-matching, a total of 131 matched pairs (N=262) were included in the analysis. Baseline characteristics were well-balanced and approximately half of the matched subjects were receiving treatment for the indication of osteomyelitis. There was no significant difference in clinical success at 90 days in the oritavancin and dalbavancin cohorts (99 [76%] vs 103 [79%], respectively; p=0.556). Similarly, there was no difference in (re-)admission or mortality, as well as change in laboratory values after initial dosing. There were significantly more unique patients who experienced an ADR in the oritavancin cohort compared to the dalbavancin cohort (9 [7%] vs 2 [2%], respectively; p=0.031).
Conclusion: There was no significant difference in clinical success between patients receiving multi-dose oritavancin and dalbavancin for OPAT for complicated infections. Both agents were generally well tolerated; however, more unique patients experienced an ADR in the oritavancin cohort.
Presenting Author
Taylor Steuber PharmD, BCPSUMKC School of Pharmacy at MU
Authors
Madeline Belk PharmD
Huntsville Hospital
Brian Boyett PharmD, BCPS
Huntsville Hospital
Hannah Gipson PharmD
Huntsville Hospital
Jonathan D. Edwards Pharm.D., BCPS-AQ ID, CGP
Huntsville Hospital
Blain Thayer PharmD
Huntsville Hospital