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Oritavancin a safe alternative to vancomycin for acute bacterial skin and skin structure infections
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Findings recently published in Open Forum Infectious Diseases showed that oritavancin can serve as a single-dose alternative to multi-dose vancomycin for treating outpatient acute bacterial skin and skin structure infections.
“The administration of multi-day intravenous antibiotics constitutes the primary reason or admission for many patients,” Thomas P. Lodise, PharmD, PhD, of Albany College of Pharmacy and Health Sciences, Albany, New York, and colleagues wrote. “Outpatient treatment of acute bacterial skin and skin structure infections has been estimated to save $2,500 to $6,500 per patient. Given current U.S. healthcare expenditures for acute bacterial skin and skin structure infections, it is critical to identify therapies that can safely and effectively shift care from the inpatient to the outpatient setting while ensuring that care can be delivered with minimal patient visits, healthcare resources and subsequent hospital admissions.”
Researchers evaluated the safety and efficacy of both vancomycin and oritavancin (Orbactiv, The Medicines Company, Parsippany, NJ) in subgroups of patients from two identical phase 3 trials. Both the SOLO I and SOLO II were multicenter, double blind, randomized trials. Patients were randomized to receive either a single 1200-mg dose of intravenous oritavancin (n = 392) or 7 to 10 days of intravenous vancomycin two times a day (n = 400). The primary outcome was a composite endpoint consisting of reduction in size or cessation of spread, no rescue antibiotic at early clinical evaluation and absence of fever. Secondary outcomes were 20% reduction in lesion area and clinical cure in 7 to 14 days after treatment. Lodise and colleagues assessed safety until day 60.
The researchers reported that both drugs produced a similar efficacy response rate at early clinical evaluation: 80.4% for oritavancin and 77.5% for vancomycin. The two medications also had a similar incidence of adverse events. In the oritavancin group, five patients (1.3%) had to be admitted to a hospital, compared with nine (2.3%) of those in the vancomycin group.
“Very few patients in the oritavancin group required subsequent care in the inpatient setting post-outpatient treatment,” the researchers wrote. “Given current U.S. health care expenditures for acute bacterial skin and skin structure infections in the inpatient setting, a single dose of oritavancin in the ambulatory setting may represent a treatment option for patients with acute bacterial skin and skin structure infections that can safely and effectively shift care from the inpatient to the outpatient setting, while minimizing outpatient health care resource use.” – by Andy Polhamus
Disclosure: Lodise is a paid consultant and speaker for The Medicines Company. Please see the full study for a complete list of all researchers’ relevant financial disclosures.
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