Clinical, organizational, and pharmacoeconomic perspectives of dalbavancin vs standard of care in the infectious disease network.

IF 0.4 Q4 HEALTH CARE SCIENCES & SERVICES Global & Regional Health Technology Assessment Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI:10.33393/grhta.2024.3094
Daniela Segala, Marco Barbieri, Mariachiara Di Nuzzo, Melissa Benazzi, Aurora Bonazza, Letizia Romanini, Brunella Quarta, Kristian Scolz, Anna Marra, Diana Campioni, Rosario Cultrera
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Abstract

Introduction: 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.

Materials and methods: 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.

Results: 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).

Conclusions: 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.

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从临床、组织和药物经济学角度看达巴万星与传染病网络中的标准护理。
导言:急性细菌性皮肤和皮肤结构感染(ABSSSI)和复杂性感染患者的治疗方法通常涉及从静脉注射治疗到口服治疗的早期过渡(早期转换)或早期出院。我们的研究旨在评估可应用于社区医疗的可持续创新护理模式,以及达巴万星疗法与标准护理(SoC)疗法在治疗 ABSSSI 和其他革兰氏阳性感染(包括耐多药生物感染)方面的经济影响。我们还介绍了传染病网络的组织情况,该网络可优化达巴万星对 ABSSSI 和其他复杂感染的治疗:我们对意大利费拉拉 "S. Anna "大学医院在 2016 年 11 月至 2022 年 12 月期间使用达巴万星治疗的所有患者进行了回顾性研究。我们从医院的 SAP 数据库中收集了每位患者的临床信息,并利用这些信息评估了达巴万星在促进患者早日出院、缩短住院时间以及改善抗生素治疗依从性方面的影响:共有287名患者(男性165人,女性122人)参与了研究,其中62人接受了达巴万星治疗。其中 13/62 例患者在治疗结束后单次服用达巴万星,以便尽早出院。假设治疗ABSSSI或完成骨髓炎或脊椎盘炎症治疗需要住院12天,与SoC(万古霉素、利奈唑胺或万古霉素)相比,使用达巴万星治疗每名患者可减少3200多欧元的费用:结论:达巴万星已被证明是组织地区传染病网络的有效辅助治疗药物,因为其作用时间长,即使是复杂的感染患者,也可以通过门诊肠外抗菌治疗实现非住院治疗。
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来源期刊
Global & Regional Health Technology Assessment
Global & Regional Health Technology Assessment HEALTH CARE SCIENCES & SERVICES-
CiteScore
0.80
自引率
20.00%
发文量
27
审稿时长
8 weeks
期刊介绍: Global & Regional Health Technology Assessment (GRHTA) is a peer-reviewed, open access journal which aims to promote health technology assessment and economic evaluation, enabling choices among alternative therapeutical paths or procedures with different clinical and economic outcomes. GRHTA is a unique journal having three different editorial boards who focus on their respective geographical expertise.
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