Comparative Effectiveness of Long-Acting Lipoglycopeptides vs Standard-of-Care Antibiotics in Serious Bacterial Infections

作者：David Goodman‐Meza, Robert E. Weiss, Michelle Poimboeuf, Jeffrey Feng, Tara Vijayan, Marianne Martinello, Gail Matthews, Gregory J. Dore · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.11641 · 被引用次数：11 · 研究领域：Antibiotic Use and Resistance、Antimicrobial Resistance in Staphylococcus、Antibiotic Resistance in Bacteria

Importance: Serious bacterial infections such as bacteremia, endocarditis, osteomyelitis, and septic arthritis typically require prolonged intravenous antibiotics. Long-acting lipoglycopeptides (laLGPs), such as dalbavancin and oritavancin, offer extended treatment intervals for gram-positive infections that may benefit populations with barriers to traditional treatment, including persons who use drugs (PWUD individuals). Objective: To assess the effectiveness of laLGPs in managing serious bacterial infections in both PWUD and non-PWUD populations compared with standard-of-care (SOC) antibiotics. Design, Setting, and Participants: This comparative effectiveness study using a target trial emulation framework included data extracted from the US Cerner Real World Data platform. Individuals hospitalized and discharged for serious bacterial infections between October 1, 2015, and October 1, 2022, were included in the analysis. Data were analyzed from July 7, 2023, to February 28, 2025. Intervention: Receipt of an laLGP (dalbavancin or oritavancin) vs SOC antibiotics. Main Outcome and Measures: The primary outcome measure was a composite of readmission, emergency department visit, and inpatient death or discharge to hospice within 90 days post discharge from the index admission. Analyses were stratified by PWUD and non-PWUD status. Clone censor weighting was used to emulate a per-protocol analysis. Hazard ratios (HR) of time to the composite event and 95% CIs were calculated using ...