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Abstract Background: Oritavancin is a lipoglycopeptide antibiotic indicated for the treatment of acute bacterial skin and soft tissue infections. The prolonged half-life of this agent allows for a course of therapy to be completed with a single dose.
University Hospital, Geneva Rövid összefoglaló This is a randomized, unblinded, single-centre study. After eventual surgical debridement not amputationpatients will be randomized to receive 1 of 2 targeted antibiotic regimens, in the ratio For diabetic toe osteomyelitis, the patients will be randomized between a 3 and a 6 week's arm, for soft tissue infections between 10 and 20 days. The final assessments used in the primary efficacy analysis will be obtained at the test-of-cure TOC visit approximately 60 days after treatment is stopped.
Oritavancin was added to our formulary as an option for treatment of acute bacterial skin and soft tissue infection to reduce admission and length of stay. Objective: The purpose of this study was to determine whether oritavancin is used appropriately at our hospital and to evaluate the impact to the institution.
Evaluation of Oritavancin Use at a Community Hospital
Methods: A retrospective and concurrent chart review was performed on all patients who had received oritavancin within our health system between June and December The primary endpoint was to determine the appropriateness of oritavancin use. Secondary endpoints include documenting readmission rates for patients prescribed oritavancin and assessing potential financial benefits to the institution.
No patients who received oritavancin required readmission within 14 days of therapy. Conclusions: The majority of oritavancin use at our institution is appropriate according to indication.
Oritavancin offers an outpatient option for the treatment of acute bacterial skin and soft tissue infections with the potential to decrease hospital cost by reducing admissions and length of stay.
Oritavancin is indicated for the treatment of infections caused by certain gram-positive organisms, 3 including Staphylococcus aureus and methicillin-resistant Staphylococcus aureus MRSA.
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Dosing for oritavancin does not require adjustment for patient weight, age, renal impairment, or hepatic impairment. The confirmation of noninferiority of oritavancin to vancomycin by these studies suggests that single-dose oritavancin provides an alternative to multidose antibiotic therapy for treatment of ABSSTIs.
Based on this data and potential for cost savings, oritavancin was added to the formulary of our large community hospital in June as an option to reduce admissions due to ABSSTIs. The objective of this analysis was to evaluate the use of oritavancin within our hospital since its addition to formulary, and to determine the financial impact of oritavancin use to the institution. Methods In this study approved by our hospital Institutional Review Board, a retrospective chart review was used to obtain data for all patients who had received oritavancin through our health system from June to October Data were collected from the hospital electronic medical records EMRsas well as from clinical notes documented in our pharmacy surveillance software.
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A drug utilization report was generated from the EMR and used to identify all patients who had received oritavancin during the specified time period. Based on this report, 67 patients were identified and included in the study.
The following data points were collected for each patient: age, gender, prior antibiotic use, indication for oritavancin, prescriber, and admission dates. The primary outcome of the study was to determine the appropriateness of oritavancin use by indication, using institution-specific restricted antimicrobial criteria for use for oritavancin.
Коммандер был вынужден принимать невероятные решения, совершать чудовищные поступки, на которые, как ему казалось раньше, не был способен.
Based on these criteria for use and FDA-approved indication, oritavancin use was considered appropriate if used in the treatment of patients with ABSSTIs, including cellulitis, cutaneous abscess, and wound infections. Use in patients for the treatment of non—FDA-approved indications, such as osteomyelitis and bacteremia, was considered inappropriate for the purpose of this study.
Secondary outcomes included the number of readmissions in patients treated with oritavancin and the financial impact of oritavancin use to our institution.
Diabetic Foot Infections: Toe to Toe
A readmission was documented for any patient who returned to our health system within 14 days of oritavancin administration. Readmission data were only collected for patients who presented back with complaints of the same infectious process.
Potential financial benefit was calculated nice guidelines diabetic foot osteomyelitis comparing the cost of hospitalization for inpatient treatment of an ABSSTI with the cost of a dose of oritavancin.
The cost of inpatient treatment was calculated by multiplying the duration of hospitalization in days by the cost-per-day of a hospital bed. Potential financial benefit was assessed using B pricing for drug acquisition cost and a national average for cost-per-day for treatment of ABSSTIs.
An institution-specific length of stay 6. Results A total of 67 patients were identified and included in this study.
Patient age ranged from 19 to 90 years old, with a mean age of A list of the indications for which oritavancin was prescribed in this population is reported in Table 1.
The most common appropriate indication for which oritavancin was used was nice guidelines diabetic foot osteomyelitis Table 1.