839. Telavancin in the Treatment of Staphylococcus aureus Bacteremia
Session: Poster Abstract Session: Bacteremia and Endocarditis
Friday, October 9, 2015
Room: Poster Hall
Posters
  • saravolatz tlv 9-29-15.pdf (362.8 kB)
  • Background:  Telavancin (TLV) is approved for the treatment of complicated skin and skin structure infections as well as hospital-acquired and ventilator associated pneumonia.  Based on in vitro activity and the pharmacokinetic profile, TLV may have a role in the treatment of Staphylococcus aureus bacteremia. 

    Methods: We conducted a multicenter, retrospective chart review of patients receiving Telavancin for the treatment of S.aureus  bacteremia.  After IRB approval, data were collected from 5 different medical centers across the United States.  The primary outcome measure was the percent of patients cured or improved at the end of therapy (EOT).  The secondary outcome was the percent of patients cured or improved on follow-up at least 30 days after discontinuation of therapy.

    Results: There were 34 cases of S. aureus bacteremia with 32 (94.1%) being MRSA and 2 (5.9%) MSSA.  Fourteen cases (41.1%) were endovascular and 9(26.5% were skin and skin structure infections.. At EOT, 79.4%(27/34) were considered cured/improved. Excluding the 7 patients who died at EOT, 95.8% of patients with 30 day follow up after EOT were considered cured/improved. The mean duration of TLV therapy for the cured/improved group was 21.5 ± 16.7 days versus 6.0 ± 6.3 days for the patients who died (p=0.02).  Additional antibiotics were given along with TLV in 85.3% patients for a median number of 6 (IQR 10) days in those cured/improved compared to 5 (IQR 11) days for those who died at EOT (p=0.67).  Serum creatinine increased two fold in 12.5% of patients with the mean serum creatinine rising from 1.26 ± 0.85 mg/dl at the onset of TLV to a maximum value of 1.86 ± 1.32 mg/dl.  Rises in serum creatinine did not lead to discontinuation of TLV in any patient.  The most common side effect was metallic taste in 9.1%(3/33). There were also no adverse events that led to the discontinuation of TLV therapy.

    Conclusion: When evaluated in a retrospective observational cases series in clinical practice, Telavancin therapy for S. aureus bacteremia demonstrated a favorable outcome and was well tolerated by patients.

    Louis Saravolatz, MD, FIDSA, Internal Medicine, St. John Hospital and Medical Center, Grosse Pointe Woods, MI, Kerry Cleveland, MD, FACP, FIDSA, FSHEA, Infectious Diseases, University of Tennessee Health Sciences Center, Memphis, TN; Methodist University Hospital, Memphis, TN, Khalid Rikabi, MD, Geographic medicine services, Biloxi, MS, Ali Hassoun, MD FIDSA FACP, University of Alabama School of Medicine - Huntsville campus, Huntsville, AL, Leonard B Johnson, MD, FIDSA, St John Hospital and Medical Center, Grosse Pointe Woods, MI, Cedric W. Spak, MD, Baylor University Medical Center, Dallas, TX, Sharon Valenti, CNP, St. John Hospital and Medical Center, Grosse Pointe Woods, MI and Susan Szpunar, PhD, Graduate Medical Education, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    L. Saravolatz, None

    K. Cleveland, None

    K. Rikabi, theravance subinvestigator: Grant Investigator , Grant recipient

    A. Hassoun, None

    L. B. Johnson, None

    C. W. Spak, Theravance: Investigator , Research grant

    S. Valenti, None

    S. Szpunar, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.