Dalbavancin Use in the Emergency Department Setting

Area of Science:

• Infectious Diseases
• Pharmacology
• Health Services Research

Background:

• Dalbavancin (DBV) offers a one-time dosing strategy ideal for outpatient settings.
• The optimal use of DBV for acute bacterial skin and skin structure infections (ABSSSIs) requires further investigation.

Purpose of the Study:

• To compare ABSSSI treatment outcomes between patients receiving DBV in the ED under standard care versus a telehealth program.
• To evaluate the efficacy and safety of DBV administration in an emergency department (ED) setting.

Main Methods:

• Retrospective cohort study of patients receiving DBV at three urban EDs.
• Primary endpoint: ABSSSI recurrence rate.
• Secondary endpoints: Hospital admission rates and ED length of stay (LOS).

Main Results:

• Telehealth criteria (TC) cohort (n=42) showed 14% recurrence vs. initial criteria (IC) cohort (n=23) with 22% recurrence.
• Median ED LOS was significantly shorter in the TC cohort (5 hours) compared to the IC cohort (25 hours).
• Fewer patients in the TC cohort required inpatient admission (0%) versus the IC cohort (9%).

Conclusions:

• DBV can be safely administered in the ED with telehealth follow-up for ABSSSI management.
• Structured patient selection criteria enhance DBV candidate selection in the ED.
• This approach effectively minimizes ABSSSI recurrence and hospital readmissions.