OBJECTIVES: Various studies have stablished the relationship between the length of stay (LoS) in intensive-care units and the risk of contracting a nosocomial infection. On the other hand, treatment with long-acting dalbavancin was associated with shorter hospital LoS compared to glycopeptide treatment. We aimed to estimate the number of nosocomial infections potentially avoided due to a shorter hospital LoS when dalbavancin (1500 mg, 30-minute IV infusion) is used instead of vancomycin.

METHODS: A previous study predicting the risk of nosocomial methicillin-resistant S. aureus (MRSA) infection based on the Acute Physiology and Chronic Health Evaluation (APACHE-II score) and hospital LoS (Ochotorena et.al. 2019) was used to model the number of nosocomial MRSA infections that could be avoided in Spain by using dalbavancin instead of vancomycin for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Reduction of hospital LoS associated to dalbavancin versus vancomycin was calculated according to various published articles. The target population was calculated according to the data recorded in the Minimum Basic Data Set in Spain (CIE10: L08). Different progressive scenarios of hospital LoS were explored.

RESULTS: 6.340 patients, potentially treated with dalbavancin or vancomycin for ABSSSIs, were defined as the target population. For severe ABSSSI infections of 14 days of hospital stay, 132 nosocomial SARM infections could be potentially avoided in the target population if dalbavancin is the treatment of choice instead of vancomycin. For more serious infections (20, 25 and 30 days of LoS), the number of nosocomial SARM infections potentially avoided are 308, 309 and 268, respectively. The peak of nosocomial infections avoided (313) is observed at 24 days of hospital stay.

CONCLUSIONS: Our results show that using dalbavancin as the antibiotic of choice in the treatment of ABSSSIs in Spain is associated with a lower risk of nosocomial infection and several SARM infections could be avoided.