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.
R. S. Britt,
K. R. Reveles, Merck: Grant Investigator , Research grant
N. K. Boyd, None
K. E. Evoy, None
C. R. Frei, None
See more of: Poster Abstract Session