Conference Correspondent

Expediting Discharge in Acute Bacterial Skin and Skin Structure Infections: Comparing Vancomycin with Oritavancin

Conference Correspondent - IDWeek 2018

Acute bacterial skin and skin structure infections (ABSSSIs) exact a high economic burden on hospitals, and discharging patients earlier from the acute care setting in the course of treatment is a potential strategy to decrease infection recurrences and avoid increased costs.

In this retrospective study conducted between May 2017 and January 2018, all hospital inpatients who received oritavancin and/or vancomycin for the treatment of ABSSSI to expedite discharge were included for evaluation of the 30-day readmission rate for recurrent infections. In addition, the researchers conducted a financial analysis based on the patients’ diagnosis-related group, applying hospital-specific expenditures.

A total of 51 patients receiving oritavancin and 50 patients receiving vancomycin were identified as meeting inclusion criteria. Nine of 50 patients (18%) in the vancomycin arm returned for recurrent infections, whereas only 2 of 51 (4%) in the oritavancin arm returned (P = .0279). Of the 11 patients with recurrent infections, 6 (55%; [0 intravenous oritavancin and 6 intravenous vancomycin]) were current intravenous drug users, 3 (27% [0 intravenous oritavancin and 3 intravenous vancomycin]) left against medical advice at their initial visit, and 7 (64% [1 intravenous oritavancin and 6 intravenous vancomycin]) had an emergency department visit in the prior 30 days for the same infection. Overall, 111.7 hospitalization days were avoided in the 51 patients receiving oritavancin, resulting in an estimated cost avoidance of $172,996 compared with conventional vancomycin treatment. That is exclusive of the readmission costs for hospitalization days ($16,500 for intravenous oritavancin and $99,000 for intravenous vancomycin). Lab costs were not included in this analysis.

Utilizing oritavancin to expedite discharge in hospitalized patients appears to be an effective treatment for ABSSSI, resulting in reduced healthcare costs.

Source: Whittaker C, et al. IDWeek 2018. Abstract 288.

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