307. Outpatient Parenteral Antibiotic Therapy (OPAT) with Telavancin:  A Multi-Center Experience
Session: Poster Abstract Session: Antimicrobial Therapy: Clinical Studies
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • Poster_307.pdf (435.1 kB)
  • Background:  Telavancin (TLV) is a novel lipoglycopeptide FDA approved September 2009 for the treatment of acute bacterial skin and skin structure infections (SSI) caused by susceptible gram positive bacteria.  To date, there is little data regarding OPAT use of TLV.  A physician office infusion center (POIC) provides an optimal outpatient setting for the treatment of SSI and other serious infections caused by gram positive bacteria.  This study's purpose was to evaluate all uses, on- and off-label, therapy characteristics and outcomes of patients (pts) receiving OPAT with TLV in POICs.   

    Methods:   A retrospective database and chart review of 15 POICs was conducted to identify all pts receiving TLV from November 1st, 2009 through December 31st, 2010 for OPAT therapy.  Patient demographics, diagnosis, therapy characteristics, adverse events (AEs) and primary outcomes were evaluated.  

    Results: 47 pts met inclusion criteria.  Pts were treated for SSI (24, 51%), osteomyelitis (OM), (19, 40%), sepsis (S), (3, 6%) and pneumonia (P), (1, 2%).    Mean age was 56 yrs with 49% males.  Common comorbidities were hypertension (19, 40%) and diabetes (18, 38%).  The most prevalent pathogen reported was MRSA (22, 47%). Mean duration of therapy was 25 days (SSI-14, OM-38, P-36, S-19).  Outcome was evaluated in 39/47 pts.  Cure was reported in 17/39 (44%), improvement in 11 (28%), failure in 11 (28%).  Outcomes in SSI were cure in 6/17 (35%), improving in 6 (35%), failure in 5 (29%) with 4 due to an AE.  Outcomes in OM were cure in 7/18 (39%), improving in 5 (28%), failure in 6 (33%) with 3 due to an AE. The P patient was cured (100%) and the 3 pts with sepsis were cured (100%).  Overall, AEs occurred in 24 pts (51%). Serious adverse events occurred in 5 (8%) and included hematologic changes (3), nephrotoxicity (1), and bardycardia with QT prolongation (1). Treatment discontinuations due to adverse events occurred in 8 pts (17%) due to severe nausea (4-SSI), rash (1-SSI, 1-OM), hematologic changes (1-OM), nephrotoxicity (1-SSI) and QT prolongation (1-OM).

    Conclusion:  TLV therapy may be successful in treatment of SSI and additional off-labeled diagnoses in the OPAT setting but AE and discontinuation rates were notable.  Additional prospective studies are warranted.

     


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Robin H. Dretler, MD, Infectious Disease Specialists of Atlanta, P.C., Decatur, GA, John S. Adams, MD, Knoxville Infectious Disease Consultants, P.C., Knoxville, TN, Michael P. Dailey, MD, Infectious Disease Services of Georgia, Roswell, GA and Lucinda J. Van Anglen, PharmD, Healix Infusion Therapy, Inc., Sugar Land, TX

    Disclosures:

    R. H. Dretler, Healix: Business management services, Business management services

    J. S. Adams, Healix: ,

    M. P. Dailey, Healix: ,

    L. J. Van Anglen, Astellas: Scientific Advisor, Consulting fee

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