Cost Effectiveness of Dalbavancin, Oritavancin in Acute Skin Infections
Dalbavancin and oritavancin are approved for treatment of ABSSSI and, due to their long half-life, are dosed as a one-time infusion.
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Dalbavancin and oritavancin may reduce the length of hospital stay in patients with acute bacterial skin and skin structure infections, but the high cost of treatments offset the potential cost savings from preventing complications and reduced hospital length of stay, according to recent research presented at IDWeek 2017, held October 4-8 in San Diego, California.
In a retrospective chart review of cases with acute bacterial skin and skin structure infections at a single facility, candidates for oritavancin or dalbavancin were identified using the hospital's Antimicrobial Stewardship Committee-approved criteria. A retrospective cost analysis was performed to determine the potential cost savings that could result from the use of dalbavancin or oritavancin over the traditional antibiotic therapy being used.
Of the 294 identified cases, 8 patients (3%) met the criteria for dalbavancin or oritavancin. The majority of these patients (n = 6/8) were intravenous drug users.
The researchers estimated that the use of dalbavancin or oritavancin would result in an additional cost of $937 to $20,107 per year at the facility.
However, the researchers predicted that the use of dalbavancin would have significantly shortened the mean (SD) length of hospital stay in dalbavancin or oritavancin candidates from 4.3 (±2.8) days (actual length) to 3.0 (1.9) days (predicted length of stay; P =.03). Moreover, use of dalbavancin or oritavancin would have potentially prevented 4 readmissions, 2 peripherally inserted central catheters, and 1 use of daptomycin.
The study investigators concluded that "careful selection of candidates for inpatient use of dalbavancin and oritavancin can benefit certain patients without negatively impacting [the facility's] pharmacy budget."
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Koutsari C, Gens K, Holt J. Evaluation of dalbavancin and oritavancin as cost-effective treatments of acute bacterial skin and skin structure infections in hospitalized patients. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, California; Poster 261.