A team of 国产短视频 researchers hopes to treat severe staph infections in the hospital and home by using a simpler and more efficient technique with far less stress to patients than traditional treatment.
The treatment tested use of an antibiotic called dalbavancin 鈥� also known under its brand name, Dalvance 鈥� as a possible alternative to antibiotics that must be administered intravenously over weeks and even months. The drug shows promise in fighting Staphylococcus aureus bacteria, the leading cause of death by bloodstream infections worldwide.
The study included evaluating patients with MRSA, or Methicillin-resistant Staphylococcus aureus, an especially severe form of staph infections that resist treatment with many standard antibiotics.
The multi-site study, published today in the , found dalbavancin to be as safe and effective as the current standard of care for treatment of complicated staph infections, said Kami Kim, MD, professor of medicine and director of the Division of Infectious Disease and International Medicine in the 国产短视频Health Morsani College of Medicine.
鈥淪evere staph needs to be treated for a prolonged period, and we have a new choice for the final weeks of treatment that doesn鈥檛 require an indwelling line and is more convenient for patients,鈥欌�� Dr. Kim said. 鈥淚n the past, some of these patients would have to stay in the hospital for their duration of treatment because there were no safe options to treat outside a hospital setting.鈥欌��
Along with its medical potential, the new option takes only 30 minutes to administer intravenously and could significantly reduce treatment costs, Dr. Kim added.
鈥淭his should decrease the length of stay in the hospital, especially for individuals who don鈥檛 have health care coverage,鈥欌�� Dr. Kim said. 鈥淪o, we have an alternative that should be safe, effective and more convenient for patients. It should also decrease costs and increase hospital capacity because of shorter lengths of stays.鈥欌��
国产短视频and Tampa General Hospital were one site for funded by the National Institutes of Health and conducted by Duke University Clinical Research Center and other academic medical centers across the country via the .
Dr. Kim served as site principal investigator at USF-TGH and is a co-author of the JAMA article. She also is medical director of infectious disease at Tampa General Hospital.
Dr. Kim recruited patients with serious staph who needed treatment, often four times a day for six to eight weeks. They required a catheter and monitoring by a health care provider. This demanding process can lead to additional infections and requires frequent lab tests to monitor toxicities. Prolonged intravenous antibiotics can lead to various complications, such as secondary infections and clots in the line, which limit normal activities, such as swimming or bathing.
鈥淭he subjects we recruited (for dalbavancin) were delighted that they only needed two more injections and could go home without an IV,鈥欌�� Dr. Kim said. 鈥淥f course, we still monitored the subjects for the study, but in between these check-ins they could go about their normal life.鈥欌��
Another 国产短视频Health professor of Infectious Disease, Kartik Cherabuddi, MD, chief hospital epidemiology officer at Tampa General, also is a co-author of the JAMA paper.
"Complicated Staph aureus infections often strike people in their prime and have high mortality,'' said Dr. Cherabuddi. "Weeks of IV antibiotics, the usual treatment, are difficult and risky, and this trial data shows Dalbavancin works just as well and offers a practical alternative. It may improve patient compliance and outcomes in real world practice."
Dalbavancin is a long-acting cousin of vancomycin, a powerful 鈥渁ntibiotic of last resort鈥� often used when other antibiotics have failed. Dalbavancin is used to treat acute bacterial skin and skin structure infections.
Because staph is a serious condition and not all infections are cured, hospitals will need to choose, educate and monitor patients carefully.
鈥淲e hope there won鈥檛 be complications,鈥欌�� Dr. Kim said. 鈥淏ut patients will need to maintain contact with their physicians to ensure they are cured.鈥欌��
While the study didn鈥檛 show dalbavancin to be superior to conventional therapy (the control arm), it did show that using the drug in the final weeks of treatment is an effective alternative. Patients got 鈥渦sual鈥� therapy while in the hospital until their blood cultures were no longer positive.
In trials, the drug has shown high microbiologic success rates among trial subjects with staph, and high clinical success rates within existing observational cohorts, the team said. While the Food and Drug Administration has approved dalbavancin for certain acute bacterial skin infections, it has yet to endorse it for the treatment of complicated staph.
The medical team hypothesized that dalbavancin will be approved because of its similar clinical efficacy to standard treatment with fewer adverse effects. Currently, an individual dose of the drug is relatively expensive, Dr. Kim added, but most insurance will pay if the drug is approved for more clinical indications.
鈥淲e don鈥檛 know if it will be approved for this, but hopefully it will,鈥欌�� Dr. Kim said. 鈥淲e鈥檒l need to develop the infrastructure so that patients are followed and supported as outpatients.鈥欌��
Photo by Ryan Rossy, 国产短视频Health Communications