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Can Outpatient Oritavancin Therapy Prevent Hospital Admissions for Patients With Cellulitis?

Oritavancin was approved in 2014 for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible gram-positive organisms, but can its use in the outpatient setting help prevent hospital admissions for patients with cellulitis?

In an Institutional Review Board exempt, retrospective chart review study presented at the 22nd annual Making a Difference in Infectious Diseases (MAD-ID 2019) meeting, investigators at Huntsville Hospital in Alabama compared the standard of care treatment for management of cellulitis, which involves inpatient admission and intravenous (IV) therapy, with outpatient infusion clinic administration of oritavancin to determine which is more clinically and economically advantageous. Jonathan Edwards, PharmD, BCPS-AQ ID, BCGP, ID pharmacist at Huntsville Hospital in Alabama and an investigator on the study, discussed the key findings with Contagion® (see video).

Between February 2015 and December 2018, a total of 1348 patients were included in the standard of care arm, with a payer mix of 415 privately insured, 613 government insured, and 320 non-insured patients. The average length of hospital stay for patients with ABSSSI in the inpatient group was 3.4 days, with an average loss per month for the inpatient group was $45,888. The 30-day readmission rate for patients with cellulitis was 3.6%.

A total of 201 patients were included in the outpatient oritavancin arm, with a payer mix of 75 privately insured, 92 government insured, and 34 non-insured patients. Patients in the oritavancin arm experienced an average monthly gain of $1,231, and the total number of bed days saved with outpatient oritavancin administration was 683 days throughout the study period. The 30-day readmission rate for cellulitis 0.5% in the outpatient oritavancin arm.

“Oritavancin has the potential to prevent hospital admissions for patients with cellulitis requiring IV therapy,” investigators concluded. “This therapeutic option could result in hospital days prevented, improved reimbursement, and similar admission/re-admission rates. This evaluation demonstrates that it is beneficial to utilize outpatient oritavancin instead of inpatient standard of care for the treatment of cellulitis.”

The study, “Clinical and Economic Outcomes of Inpatient Standard of Care versus Outpatient Oritavancin Therapy for Patients with Cellulitis,” was presented at MAD-ID 2019, held May 8-11, 2019, in Orlando, Florida.
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