Improving Access to Outpatient Antibiotic Therapy: Addition of Dalbavancin to a County Hospital Formulary for Complicated Staphylococcus aureus Infections

TL;DR

This paper discusses adding dalbavancin to a hospital's formulary to improve outpatient treatment for Staphylococcus aureus infections, reducing costs and logistical challenges.

Contribution

The study introduces a practical implementation of dalbavancin for outpatient therapy in a county hospital setting.

Findings

Dalbavancin was integrated into the hospital's formulary for outpatient treatment of Staphylococcus aureus infections.

Dalbavancin's cost per patient was found to be significantly lower than standard IV therapy.

The therapy plan was successfully integrated into the electronic medical record system.

Abstract

Complicated Staphylococcus aureus infections often require prolonged intravenous (IV) antibiotic therapy, which poses challenges for patients, particularly those with unstable housing or substance use disorders, and leads to increased healthcare costs. Logistical barriers, including frequent lab monitoring and the need for nurse visits, add complexity to traditional outpatient antibiotic therapy. This study describes the integration of dalbavancin, a long-acting lipoglycopeptide antibiotic, into a county hospital's formulary as an outpatient therapy alternative for patients unsuitable for standard IV therapy. Dalbavancin has demonstrated clinical efficacy in treating infective endocarditis and osteomyelitis. One of our local hospitals’ internal data indicated that dalbavancin's cost per patient is significantly lower than standard care. This article discusses dalbavancin administration implementation via an infusion center post-discharge. The therapy plan, including dosing instructions and coordination mechanisms, was integrated into the electronic medical record system to streamline administration.