Dataset Information

Oritavancin as sequential therapy for Gram-positive bloodstream infections.

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 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

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

SUBMITTER: Texidor WM

PROVIDER: S-EPMC10807122 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Oritavancin as sequential therapy for Gram-positive bloodstream infections.

Texidor Williams Monier WM Miller Matthew A MA Molina Kyle C KC Krsak Martin M Calvert Barbara B Hart Caitlin C Storer Marie M Fish Douglas N DN

BMC infectious diseases 20240124 1

<h4>Background</h4>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 consolidative treatment of Gram-positive bloodstream infections (BSI), including infective endocarditis (IE).<h4>Methods</h4>We conducted a retrospective cohort study evaluating adult patients admitted to Univers ...[more]

PMID: 38267844

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Dataset Information

Oritavancin as sequential therapy for Gram-positive bloodstream infections.

Background

Methods

Results

Conclusions

Publications

Oritavancin as sequential therapy for Gram-positive bloodstream infections.

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