Oritavancin as sequential therapy for Gram-positive bloodstream infections

Oritavancin as sequential therapy for Gram-positive bloodstream infections

Blog Article

Abstract Background Oritavancin, a long-acting lipoglycopeptide approved for use in acute bacterial skin and skin structure infections, has limited data evaluating use in serious infections due to Gram-positive organisms.We aimed to assess the effectiveness and safety of oritavancin for Sweatshirt consolidative treatment of Gram-positive bloodstream infections (BSI), including infective endocarditis (IE).Methods We conducted a retrospective cohort study evaluating adult patients admitted to University of Colorado Hospital from March 2016 to January 2022 who received ≥ 1 oritavancin dose for treatment of Gram-positive BSI.

Patients were excluded if the index culture was drawn at an outside facility or were > 89 years of age.The primary outcome was a 90-day composite failure (clinical or microbiological failure) in those with 90-day follow-up.Secondary outcomes included individual components of the primary outcome, acute kidney injury (AKI), infusion-related reactions (IRR), and institutional cost avoidance.

Results Overall, 72 patients were included.Mean ± SD age was 54 ± 16 years, 61% were male, and 10% had IE.Organisms most commonly causing BSI were Staphylococcus aureus (68%, 17% methicillin-resistant), followed by Streptococcus spp.

(26%), and Enterococcus spp.(10%).Patients received standard-of-care antibiotics before oritavancin for a median (IQR) of 11 (5–17) days.

Composite failure in the clinically evaluable population (n = 64) at 90-days occurred in 14% and was composed of clinical and microbiological failure, which occurred in 14% and 5% of patients, respectively.Three patients (4%) experienced AKI after oritavancin, and two (3%) experienced an IRR.Oritavancin utilization resulted in earlier discharge for 94% of patients corresponding to an institutional cost-avoidance of $3,055,804 (mean $44,938/patient) from 1,102 hospital days saved (mean 16 days/patient).

Conclusions Military Helicopter Kit The use of oritavancin may be an effective sequential therapy for Gram-positive BSI to facilitate early discharge resulting in institutional cost avoidance.