加拿大静脉注射达巴万星的实际使用经验;CLEAR(加拿大抗菌药物实际使用领导力)登记的结果。

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2024-06-20 DOI:10.1016/j.jgar.2024.06.002
George Zhanel , Michael Silverman , Janhavi Malhotra , Melanie Baxter , Reza Rahimi , Neal Irfan , Gabriel Girouard , Rita Dhami , Melissa Kucey , Vida Stankus , Kristin Schmidt , Sébastien Poulin , William Connors , Carlo Tascini , Andrew Walkty , James Karlowsky
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引用次数: 0

摘要

目的我们利用国家 CLEAR 登记处采集的数据报告了加拿大患者静脉注射达巴万星的使用情况:CLEAR登记处使用基于网络的数据管理程序REDCapTM(在线调查 https://rcsurvey.radyfhs.umanitoba.ca/surveys/?s=TPMWJX98HL),方便临床医生输入与他们使用静脉注射达巴万星的临床经验相关的详细信息:结果:共获得 40 名患者的数据。最常见的感染是急性细菌性皮肤和皮肤结构感染(ABSSSI)(62.5%的患者)、骨/关节感染(22.5%)、血流/血管感染(7.5%)和心内膜炎(5.0%)。达巴万星用于指导性治疗(75.0%)和经验性治疗(25.0%)。MRSA 是最常见的病原体(70.0%)。达尔巴万星既用于门诊(如急诊科)(65.0%),也用于住院治疗环境(如病房)(35.0%)。使用达尔巴万星的原因是单剂量治疗方便(77.5%)以及便于出院(7.5%)。达尔巴万星主要用于单药治疗(90.0%),最常用的是单剂量 1500 毫克(77.5%)。88.2%的已知病例取得了微生物学治疗成功(病原体根除或假定根除),93.3%的已知病例取得了临床治疗成功(治愈和/或病情好转)。无不良反应报告:在加拿大,静脉注射达巴万星既可作为指导疗法,也可作为经验疗法,用于治疗ABSSSI以及标签外(骨/关节、菌血症/血管、心内膜炎、设备相关)感染。它既可用于门诊病人,也可用于住院病人,这主要是因为它是一种方便的单剂量治疗方案,便于病人尽早出院。达尔巴万星的微生物学和临床治愈率都很高,而且安全性极佳。
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Real-life experience with IV dalbavancin in Canada; results from the CLEAR (Canadian LEadership on Antimicrobial Real-life usage) registry

Objectives

We report the use of IV dalbavancin in Canadian patients using data captured by the national CLEAR registry.

Methods

The CLEAR registry uses the web-based data management program, REDCap™ (online survey https://rcsurvey.radyfhs.umanitoba.ca/surveys/?s=TPMWJX98HL) to facilitate clinicians entering details associated with their clinical experiences using IV dalbavancin.

Results

Data were available for 40 patients. The most common infections treated were acute bacterial skin and skin structure infection (ABSSSI) (62.5% of patients), bone/joint infection (22.5%), bloodstream/vascular infection (7.5%) and endocarditis (5.0%). Dalbavancin was used as directed (75.0%) and empiric therapy (25.0%). MRSA was the most common identified pathogen (70.0%). Dalbavancin was used both in outpatient (e.g., emergency department) (65.0%), and inpatient treatment settings (e.g., hospital ward) (35.0%). Dalbavancin was used due to the convenience of a single dose treatment (77.5%) as well as to facilitate hospital discharge (7.5%). Dalbavancin was primarily used alone (90.0%), and most commonly using a single 1500 mg dose (77.5%). Microbiological success (pathogen eradicated or presumed eradicated) occurred in 88.2% of known cases, while clinical success (cure and/or improvement) occurred in 93.3% of known cases. No adverse events were reported.

Conclusions

In Canada, IV dalbavancin is used as both directed and empiric therapy to treat ABSSSI as well as off-label (bone/joint, bacteremia/vascular, endocarditis, device-related) infections. It is used in both outpatient and inpatient settings due primarily to its convenience as a single-dose treatment regimen and to facilitate early hospital discharge. Dalbavancin use is associated with high microbiological and clinical cure rates along with an excellent safety profile.

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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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