1166. Comparative-Effectiveness of Ceftaroline and Daptomycin as First-line Therapy for Patients with Skin and Soft Tissue Infections Admitted to Hospitals in the United States Veterans Health Care System
Session: Poster Abstract Session: Clinical Infectious Diseases: Bone and Joint, Skin and Soft Tissue
Friday, October 28, 2016
Room: Poster Hall
Background: Skin and soft tissue infections are a common cause of hospital admission and readmission. This study compared health outcomes for patients who received first-line ceftaroline or daptomycin for their skin and soft tissue infection.

Methods: This was a retrospective, cohort, comparative-effectiveness study of adults (age 18+ years), admitted to hospitals in the United States Veterans Health Care System with skin and soft tissue infections (by ICD9 codes), between 10/1/10-9/30/14, and who received ceftaroline or daptomycin as first-line therapy within 14 days of admission. Patients who received both drugs were excluded. Chi-square, Fisher's exact, and Wilcoxon rank sum tests were used to compare baseline characteristics. Multivariable logistic regression models were used to compare health outcomes. Model covariates were variables present in >5% of patients with p-values <0.05 in bivariable analysis.

Results: A total of 451 patients were included (ceftaroline=129 and daptomycin=322). Ceftaroline patients were older, more likely to be Hispanic, had higher Charlson comorbitidy scores, and were more likely to have a history of heart failure, chronic obstructive pulmonary disease, diabetes, dyslipidemia, hospital admission, and antibiotic use. Median (25th-75th percentile) time from hospital admission to study drug initiation was 0 (0-1) days for ceftaroline and 1 (0-1) day for daptomycin. Unadjusted emergency department admission rates for ceftaroline versus daptomycin were: 30-day (20% vs. 20%), 60-day (30% vs. 27%), and 90-day (37% vs. 32%). Unadjusted hospital readmission rates were: 30-day (33% vs. 35%), 60-day (36% vs. 40%), and 90-day (40% vs. 43%). Unadjusted mortality rates were: 30-day (1% vs. 3%), 60-day (1% vs. 5%), and 90-day (4% vs. 6%). In multivariable models, ceftaroline patients were less likely than daptomycin patients to experience 60-day patient mortality (OR=0.14, 95%CI=0.01-0.76); 30/60/90-day emergency department admission, 30/60/90-day hospital readmission, and 30/90-day mortality were similar.

Conclusion: In this population, ceftaroline and daptomycin were associated with similar health outcomes for most study endpoints when used as first-line therapy for skin and soft tissue infections.

Rachel S. Britt, PharmD Student1,2, Grace C. Lee, PharmD, PhD1,2, Kelly R. Reveles, PharmD, PhD1,2, Natalie K. Boyd, PharmD, MS1,2, Kirk E. Evoy, PharmD1,2,3 and Christopher R. Frei, PharmD, MSc1,2, (1)The University of Texas at Austin, San Antonio, TX, (2)University of Texas Health Science Center, San Antonio, TX, (3)University Health System, San Antonio, TX

Disclosures:

R. S. Britt, None

G. C. Lee, None

K. R. Reveles, Merck: Grant Investigator , Research grant

N. K. Boyd, None

K. E. Evoy, None

C. R. Frei, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.