4CPS-198 Clinical experience with dalbavancin in a tertiary hospital

BackgroundVery limited labelled indications have been approved for the newer antimicrobials and extensively drug-resistant gram-positive bacterial infections that are a clinical challenge.PurposeData on the clinical uses, efficacy and safety of dalbavancin, a novel lipoglycopeptide, in real life is scarce, thus we sought to describe our clinical experience.Material and methodsDescriptive study of patients treated with dalbavancin from June 2016 to September 2017 in a tertiary hospital in southern Spain.ResultsTwenty-two patients were involved. Demographics, microbiology, therapy characteristics, adverse events and clinical outcomes are described in table 1. Eighty-six per cent were used under off-label indications in patients who had tried and/or failed other therapies.Abstract 4CPS-198 Table 1 DEMOGRAPHICS n (%) TREATMENT (%) Age69.6 (46–85)DAL administered following hospitalisation77.3%Male59.1%Previous antimicrobials for actual episode100% DIAGNOSES Switching to DALOsteoarticular infections45.5%Discharge64.7%Resistant pathogens22.7%Drug-induced toxicity13.6%Bloodstream infections22.7%Difficult vascular access9.1%Acute bacterial skin and skin structure infections13.6%Drug-drug interactions4.5%Endocarditis13.6% DAL initial – weekly doses1,000–500 mg63.3% MICROBIOLOGY750–350 mg4.5%Samples available90.9%1,500–1,500 mg4.5% S. aureus54.5%1,500 – single dose27,3% MRSA58.3% DAL number of doses: CNS27.3%236.4%Methicillin-resistant CNS66.7%single31.8% E. faecalis4.5%≥527.3% E.faecium4.5% ADVERSE EVENTS OUTCOMESInfusion site reaction4.5%Success treatment95.2%Others0ConclusionFurther evidence beyond labelled indications is urgently needed. Despite the limitations, in our clinical practice, the use of dalbavancin under multidisciplinary antimicrobial stewardship team supervision appears to be a promising, safe and effective option for adult patients who have tried and/or failed other therapies due to multidrug-resistant gram-positive organisms and/or may offer added safety and potential cost reductions.References and/or acknowledgementsNo conflict of interest.