Length of stay (LOS) for acute bacterial skin and skin structure infection (ABSSSI) hospital admissions was significantly improved after implementing dalbavancin-based therapy via the ENHANCE ABSSSI trial (ClinicalTrials.gov identifier: NCT03233438) in eligible patients, according to a poster presented at ID Week 2019, held from October 2 to October 6 in Washington, DC.

Researchers aimed to reduce LOS after ABSSSI hospital admission, using a hospital pathway that leverages long-acting intravenous antibiotic therapy with dalbavancin. Study authors conducted a single-center pre- vs postperiod pragmatic trial at Weill Cornell Medical Center in New York and evaluated care for consecutively enrolled patients with ABSSSI during the observational pre-period. A new ABSSSI pathway was implemented in the postperiod, which contained identification of eligible patients and treatment with dalbavancin.

The study included 48 patients in the pre-period and 43 patients in the postperiod. Patients with potentially fatal infections who required intensive care or multiple antibiotics or had unstable comorbidities were excluded from the study. During a 44-day follow-up period, mean infection-related LOS was reduced in the postperiod (3.2 days vs 4.8 days; P =.003). Results also showed that in the postperiod, work productivity (59.3% vs 18.0%; P =.01) and activity impairment outcomes (18.5% vs 60.2%, P <.001) significantly improved compared with the pre-period. However, quality of life remained similar between the pre- and postperiods.

The complete response to treatment was similar between both periods, whereas a greater number of adverse events occurred in the postperiod compared with the pre-period (48%, and 6%, respectively). Most adverse events were mild in severity and unrelated to the use of antibiotics.


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“After implementing the ENHANCE ABSSSI pathway among eligible patients, LOS was significantly reduced by almost 2 days, with potential improvements in work productivity and the ability to complete daily activities,” said study authors.

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

McCarthy M, Keyloun K, Gillard P, et al. Dalbavancin, a long acting lipoglycopeptide antimicrobial agent, reduces length of stay and improves patient work productivity in a hospital critical pathway for acute bacterial skin and skin structure infections (ABSSSI) – the ENHANCE ABSSSI trial. Presented at: IDWeek 2019; October 2-6, 2019; Washington DC. Poster 456.