Treatment of osteoarticular, cardiovascular, intravascular catheter-related, and other complicated infections with dalbavancin and oritavancin: a systematic review.

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Treatment of osteoarticular, cardiovascular, intravascular catheter-related, and other complicated infections with dalbavancin and oritavancin: a systematic review.

Int J Antimicrob Agents. 2020 Jun 27;:106069

Authors: Thomas G, Henao-Martínez AF, Franco-Paredes C, Chastain DB

Abstract
BACKGROUND: There is increasing interest in using oritavancin and dalbavancin for complicated Gram-positive infections as an alternative to in-hospital intravenous or outpatient antimicrobial therapy.
OBJECTIVE: To evaluate the efficacy and safety of long-acting lipoglycopeptides (laLGPs) in patients with osteoarticular, cardiovascular, intravascular catheter-related, and other complicated infections.
METHODS: A systematic literature search using was performed using "dalbavancin" and "oritavancin" as search terms. To be included, studies had to include at least one human subject treated for an indication other than acute bacterial skin and skin structure infections. The primary outcome for this review was clinical success as defined by each individual study, and patients were stratified by infection type.
RESULT: A total of 38 studies met inclusion criteria, of which 18 were randomized controlled trials or case series, and 20 were case reports. The most common off-label indication for oritavancin and dalbavancin was osteoarticular infections with a median success rate of 73% (IQR= 58%-85%) among the 14 studies with > 1 patient. The success rate for endocarditis and cardiac device-related infections was 68% (IQR= 56%-86%) among 9 studies and 75% (IQR=59%-90%) among 7 studies of catheter-related blood stream infection. Among the 16 studies of almost 700 patients receiving laLGPs, there were 98 reports of adverse events resulting in 13% of treated patients reporting an event.
CONCLUSIONS: This review provides evidence that laLGPs can be safely and efficaciously used for osteoarticular, cardiovascular, intravascular catheter-related, and other complicated infections. Further research is needed to confirm these results.

PMID: 32603683 [PubMed - as supplied by publisher]