Clinical outcomes of patients with diabetic foot ulcer treated with dalbavancin in the outpatient setting

Sarah Lawless; Elias Eltoum; Emily Madden; Avril Clancy; Ana Rueda; Carole Doherty; Siobhan Bacon; Catherine McHugh

doi:10.1530/endoabs.99.P265

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Endocrine Abstracts (2024) 99 P265 | DOI: 10.1530/endoabs.99.P265

ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)

Clinical outcomes of patients with diabetic foot ulcer treated with dalbavancin in the outpatient setting

Sarah Lawless ¹ , Elias Eltoum ¹ , Emily Madden ¹ , Avril Clancy ¹ , Ana Rueda ¹ , Carole Doherty ² , Siobhan Bacon ¹ & Catherine McHugh ¹

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¹Sligo University Hospital, Department of Diabetes, Endocrinology and Metabolism, Ireland; ²Sligo University Hospital, Department of Pharmacy, Ireland

Aims: The primary aim of this retrospective study was to examine clinical outcomes of patients with diabetic foot ulcer (DFU) and/or osteomyelitis (OM) who attended day services at Sligo University Hospital (SUH) for dalbavancin between November 2020 and August 2023. The secondary aim was to perform a cost analysis of the use of dalbavancin.

Methods: Clinical information was obtained from the Prowellness electronic patient record and laboratory results were extracted from the SUH information system.

Results: In total, data from 42 patients who received dalbavancin was collected. 37(90.2%) patients have T2DM, 9(24.3%) of which are insulin dependent, and 4(12.9%) patients carry a diagnoses of T1DM. Mean duration of diabetes is 16.1 years. Average HbA1c was 61.2 mmol/mol. We have follow up podiatry data on 34 of these patients, unfortunately, 8 patients either transferred care to another hospital or did not attend follow up clinics. 26 (76.47%) achieved remission with no active foot disease, 10 (38.5%) of these patients suffered another diabetic foot ulcer at a different site(s) post resolution. 18 of these patients have been discharged to community podiatry. Prior to the availability of dalbavancin, patients with DFU were admitted as inpatients for treatment as out-patient antimicrobial therapy (OPAT) is limited in our area. A cost analysis was performed comparing inpatient admission and outpatient treatment with dalbavancin. The average length of stay for an inpatient with diabetes in Ireland is 8+/-13 days. The Health Service Executive advised in 2019, that the cost of a hospital bed is € 878 per night. Therefore, the average cost of an admission is approximately € 7024. The current cost of a course of a complete course of dalbavancin is € 3852.

Conclusion: Patients treated with dalbavancin for DFU have had good clinical outcomes to date while avoiding inpatient admission. There is significant cost savings using this approach.