Helena Sofia Antao*, Joao Paulo Guimaraes, Filipe Froes, Joao Almeida and Sara Marques
Background: Acute bacterial skin and skin structure infections are frequent in-hospital infections. Vancomycin and linezolid are antibacterial agents commonly used in serious acute bacterial skin and skin structure infections but have been associated to prolonged length of stay. Dalbavancin is a new lipoglycopeptide antibacterial, active against Gram positive pathogens, with a long half-life, allowing for a single infusion of 1500 mg or 1000 mg followed one week later by 500 mg. The aim of this study was to assess the effect of dalbavancin on length of stay and mortality of acute bacterial skin and skin structure infections patients in Portugal.
Methods and findings: we have modelled the natural history and treatment implications of acute bacterial skin and skin structure infections using a decision analytical tree that calculated the probability of success, failure or death for dalbavancin and linezolid. Efficacy endpoints were obtained from a randomized controlled trial. LOS and mortality due to acute bacterial skin and skin structure infections were derived from non-experimental studies.
Conclusion: we estimated the average length of stay for dalbavancin in 10.4 days. Compared to linezolid this represents a 9.4 day reduction. Dalbavancin is estimated to decrease the death rate by 1.7% in serious acute bacterial skin and skin structure infections caused by Gram positive pathogens and by 1.8% in acute bacterial skin and skin structure infections caused by methicillin-resistant Staphylococus aureus.