Association of Obesity with 30-day readmission rates among patients Hospitalized with Acute Bacterial Skin and Skin-Structure Infections (ABSSSI)

Ayyagari, Rajeev; Revol, Cindy; Tang, Wenxi; Faust, Elizabeth; Tuttle, Edward

doi:10.1016/j.jval.2015.03.1073

Cited by 4 publications

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“…Obesity is also a predictor of poor outcomes, including increased treatment costs, and obese patients have higher rates of ABSSSI-related 30-day readmission than non-obese patients [33–42]. The analysis of outcome data by BMI is particularly important, as the management and treatment of infections in obese patients pose additional challenges to physicians and pharmacists [41]. Delafloxacin, administered at the standard dose of 300 mg every 12 hours IV and oral delafloxacin 450 mg every 12 hours, was found to be non-inferior to vancomycin/aztreonam, with vancomycin dosed to 15 mg/kg based upon actual body weight, and to provide good outcomes in obese patients (BMI ≥ 30 kg/m 2 ), potentially simplifying dosing in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Pooled Phase III Efficacy Data for Delafloxacin in Acute Bacterial Skin and Skin Structure Infections

Giordano

Pogue

Cammarata

2019

Clinical Infectious Diseases

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Background Delafloxacin is an oral or intravenous (IV) antibiotic indicated for the treatment of acute bacterial skin and skin structure infections (ABSSSI), including both gram-positive (including methicillin-resistant Staphylococcus aureus [MRSA]) and gram-negative organisms. Chemically distinct from other quinolones, delafloxacin exhibits enhanced potency, particularly against gram-positive pathogens. The integration of efficacy data across the Phase III ABSSSI studies is presented here and allows for additional examination of results across subgroups. Methods Results of 2 multicenter, randomized, double-blind trials of 1510 adults with ABSSSI were pooled for this analysis. Subjects in the vancomycin arm received 15 mg/kg, plus 1–2 g of aztreonam every 12 hours. Delafloxacin was dosed at 300 mg IV every 12 hours in Study 302; dosing in Study 303 was 300 mg IV every 12 hours for 3 days, with a mandatory, blinded switch to delafloxacin at 450 mg orally every 12 hours. The primary endpoint was objective response (OR), defined as a ≥20% reduction of lesion spread of erythema area at the primary infection site at 48 to 72 hours (±2 hours), in the absence of clinical failure. Investigator-assessed response, based on the resolution of signs and symptoms at follow-up (FU; Day 14 ± 1) and late follow-up (LFU; Day 21– 28), were secondary endpoints. Results In the intent-to-treat analysis set, the OR was 81.3% in the delafloxacin arm and 80.7% in the comparator arm (mean treatment difference 0.8%, 95% confidence interval -3.2% to 4.7). Results for OR in the defined subgroups showed delafloxacin to be comparable to vancomycin/aztreonam. Investigator-assessed success was similar at FU (84.7% versus 84.1%) and LFU (82.0% versus 81.7%). Delafloxacin was comparable to vancomycin/aztreonam in the eradication of MRSA, at 98.1% versus 98.0%, respectively, at FU. The frequencies of treatment-emergent adverse events between the groups were similar. Conclusions Overall, IV/oral delafloxacin fixed-dose monotherapy was non-inferior to IV vancomycin/aztreonam combination therapy and was well tolerated in each Phase III study, as well as in the pooled analysis, regardless of endpoint or analysis population.

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Section: Discussionmentioning

confidence: 99%

Analysis of Pooled Phase III Efficacy Data for Delafloxacin in Acute Bacterial Skin and Skin Structure Infections

Giordano

Pogue

Cammarata

2019

Clinical Infectious Diseases

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“…Obese patients with ABSSSIs are at a higher risk of treatment failure and have demonstrated slow recovery [ 24 , 25 ] According to the World Health Organisation, globally 39% adults (≥ 18 years) were overweight, whilst about 13% of the world’s adult population was obese in 2016, making it a clinically important subpopulation of interest [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of delafloxacin for complicated and acute bacterial skin and skin structure infections: results from a network meta-analysis

et al. 2021

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Background Delafloxacin is a novel fluoroquinolone with broad antibacterial activity against pathogens causing acute bacterial skin and skin structure infections (ABSSSI). This network meta-analysis (NMA) was conducted to evaluate the relative efficacy of delafloxacin versus other comparators used for managing patients with ABSSSI. Methods A systematic literature review was conducted to identify randomised controlled trials (RCTs) evaluating adults (≥ 18 years) with ABSSSI, complicated SSSI (cSSSI), complicated skin and soft tissue infections (cSSTI) or severe cellulitis with pathogen of gram-positive, gram-negative, or mixed aetiology. OVID MEDLINE®, Embase, Epub Ahead of Print, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched from inception through 12 April 2019. A feasibility assessment was conducted, followed by an NMA, which was run in a Bayesian framework. The interventions included in the NMA encompassed monotherapy or combination therapies of amoxicillin/clavulanate, ampicillin/sulbactam, ceftaroline, ceftobiprole, dalbavancin, daptomycin, delafloxacin, fusidic acid, iclaprim, linezolid, omadacycline, oxacillin + dicloxacillin, standard therapy, tedizolid, telavancin, tigecycline, vancomycin, vancomycin + aztreonam and vancomycin + linezolid. Results A feasibility assessment was performed and evidence networks were established for composite clinical response (n = 34 studies), early clinical response (n = 16 studies) and microbiological response (n = 14 studies) in the overall study population, composite clinical response (n = 4 studies) in obese subpopulation and for composite clinical response (n = 18 studies) and microbiological response (n = 14 studies) in patients with methicillin-resistant Staphylococcus aureus (MRSA) infection. Delafloxacin performed significantly better than fusidic acid, iclaprim, vancomycin, and ceftobiprole for composite clinical response. Delafloxacin was comparable to dalbavancin, daptomycin, fusidic acid, iclaprim, linezolid, omadacycline, tedizolid, vancomycin, vancomycin + aztreonam and vancomycin + linezolid in the analysis of early clinical response, whereas for microbiological response, delafloxacin was comparable to all interventions. In the obese subpopulation, the results favoured delafloxacin in comparison to vancomycin, whilst the results were comparable with other interventions among the MRSA subpopulation. Conclusions Delafloxacin is a promising new antibiotic for ABSSSI demonstrating greater improvement (composite clinical response) compared to ceftobiprole, fusidic acid, iclaprim, telavancin and vancomycin and comparable effectiveness versus standard of care for all outcomes considered in the study.

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“…In the critical care setting, the provision of adequate nutrition support to patients who have severe obesity is challenging [ 42 ], and patients who have obesity appear to have lower mortality but an increased risk of complications in several organ systems [ 18 ]. Obesity is also an independent risk factor for hospital readmission following surgery, such as total joint arthroplasty [ 43 ], cardiac surgery [ 41 ], and exacerbation of chronic health conditions [ 38 , 44 ], including mental health conditions [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring Overnutrition, Overweight, and Obesity in the Hospital Setting—A Point Prevalence Study

et al. 2023

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Malnutrition is an international healthcare concern associated with poor patient outcomes, increased length of stay, and healthcare costs. Although malnutrition includes both under and overnutrition, there is a large body of evidence that describes the impacts of undernutrition with limited data on overnutrition in hospitalized patients. Obesity itself is a modifiable risk factor associated with hospital-associated complications. However, there is limited reporting of the prevalence of obesity in hospitals. This one-day cross-sectional study (n = 513) captures the prevalence of both under and overnutrition in a hospitalized population and explores dietetic care provided compared to the Nutrition Care Process Model for hospitalized patients who have obesity. The main findings were: (1) the largest proportion of patients were in the overweight and obese classifications (57.3%, n = 294/513); 5.3% of these patients had severe obesity (class III); (2) patients who were overweight and obese had lower malnutrition risk profiles as well as the prevalence of malnutrition; (3) 24.1% of patients who had obesity (n = 34/141) were receiving dietetic intervention; (4) 70.6% (n = 24/34) did not have a nutrition diagnosis that followed the Nutrition Care Process Model. Study results provide valuable clinical insight into the prevalence of overnutrition and opportunities to improve nutrition care for this vulnerable patient group.

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Association of Obesity with 30-day readmission rates among patients Hospitalized with Acute Bacterial Skin and Skin-Structure Infections (ABSSSI)

Cited by 4 publications

References 0 publications

Analysis of Pooled Phase III Efficacy Data for Delafloxacin in Acute Bacterial Skin and Skin Structure Infections

Analysis of Pooled Phase III Efficacy Data for Delafloxacin in Acute Bacterial Skin and Skin Structure Infections

Comparative efficacy of delafloxacin for complicated and acute bacterial skin and skin structure infections: results from a network meta-analysis

Exploring Overnutrition, Overweight, and Obesity in the Hospital Setting—A Point Prevalence Study

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