英国一家三级转诊医院使用达巴万星三年的情况,该医院为大量注射吸毒者提供服务。

IF 3.7 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2024-05-06 eCollection Date: 2024-06-01 DOI:10.1093/jacamr/dlae066
Carolin Bresges, Kristina Bresges, Claudette Hewitt, Sunil Sharma, Bethany Davies
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引用次数: 0

摘要

背景:达巴万星具有独特的特性,因此越来越多地用于复杂感染和易感人群,包括注射吸毒者(PWID),但数据仍然有限。在这项回顾性队列研究中,我们描述了英国一家三级医院所有接受达巴万星治疗的成年住院患者的特征、治疗原理和结果:2018年1月1日至2021年1月1日期间,58名住院患者接受了达巴万星治疗,98.3%的患者接受了非许可诊断。22.4%的患者被诊断为急性细菌性皮肤和皮肤结构感染、感染性心内膜炎和血管内感染。18.9%的患者确诊为骨与关节感染,12.1%的患者确诊为椎间盘炎,5.2%的患者确诊为中心管路相关性血流感染。69%的患者出现菌血症;52.5%为金黄色葡萄球菌,5.0%为 MRSA。达巴万星引起了两种轻微不良反应。43例(75.4%)患者治疗成功,7例(12.3%)治疗失败。35名患者(60.3%)为吸毒者,年龄中位数(41.0岁)和查尔森综合症评分(0)均较低。17.1%的吸毒者自行出院,20.6%的患者失去随访。90天后,3名(8.6%)吸毒者死亡:结论:在英国的首个队列中,达巴万星在未获得许可的情况下被用于面临常规疗法障碍的人群。在有数据可查的情况下,达巴万星是安全有效的。达尔巴万星似乎是改善吸毒者治疗效果的一种潜在的有价值的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Three-years of dalbavancin use at a UK tertiary referral hospital serving a population with high numbers of people who inject drugs.

Background: Dalbavancin's unique properties have led to an increase in its off-licence use in complex infection and in vulnerable populations including people who inject drugs (PWID), but data remain limited. In this retrospective cohort study, we describe the characteristics, treatment rationale and outcomes for all adult inpatients treated with dalbavancin at a UK tertiary hospital.

Results: Fifty-eight inpatients were treated with dalbavancin between 1 January 2018 and 1 January 2021, 98.3% for off-licence diagnoses. Acute bacterial skin and skin structure infection, infective endocarditis and endovascular infections were each diagnosed in 22.4% of patients. Bone and joint infections were diagnosed in 18.9%, discitis in 12.1% and central line-associated bloodstream infections in 5.2%. Sixty-nine percent of patients were bacteraemic; 52.5% Staphylococcus aureus, 5.0% MRSA. Two mild adverse reactions were attributed to dalbavancin. Treatment was successful in 43 (75.4%) patients, and failed in seven (12.3%). Seven (12.3%) were lost to follow-up.Thirty-five patients (60.3%) were PWID, with low median age (41.0 years) and Charlson Comorbidity scores (0). Self-discharge was taken by 17.1% of PWID, and 20.6% were lost to follow-up. At 90 days, three (8.6%) PWID were deceased.

Conclusions: In this first UK cohort, dalbavancin was used off licence and in persons facing barriers to conventional therapies. Where data is available, it was safe and effective. Dalbavancin appears a potentially valuable tool in improving outcomes for PWID.

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CiteScore
5.30
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