Emergency department care of ABSSSI with dalbavancin infusion, direct discharge, and outpatient telemedicine follow up: a study protocol

Abstract

Novel therapeutic strategies such as the long-acting lipoglycopeptide antibiotics allow for the treatment and discharge of selected emergency department (ED) patients with Acute Bacterial Skin and Skin Structure Infections (ABSSSI), who require intravenous antibiotics and would otherwise be hospitalized. The COVID-19 pandemic highlighted the need to develop strategies that may reduce hospitalization. The telehealth approach has shown success in remote management of cellulitis patients and could aid in the remote follow up of overall ABSSSI patients. This article describes a study protocol for the telemedicine follow up of patients diagnosed with ABSSSI in the ED, requiring intravenous treatment, receiving a single dalbavancin dose, and directly discharged. A telehealth system for remote follow up is evaluated as well as the possible inclusion of point-of-care ultrasound for the appropriate diagnosis of ABSSSI. The study will be conducted in compliance with regulatory requirements; and all collected data will be kept strictly confidential and in accordance with all relevant legislation on the control and protection of personal information. Dissemination of the study protocol may help increasing knowledge and awareness on this topic, with the aim of optimizing patient management, reducing hospitalization and lower the impact on healthcare associated costs.

Keywords:

• Dalbavancin
• emergency department
• gram-positives
• skin and soft tissue infections
• telehealth follow-up

Acknowledgements

We kindly thank Claudia Laterza, MD from Sanitanova S.r.l. for her support in conceptualization and manuscript editing; and Regina Picozzi, MD for the support in medical writing.

Disclosure statement

EDM has received research funding for his Institution from MSD, Pfizer, Advanz pharma, Nordic pharma and received speaker’s honoraria or has participated in advisory boards or has been in the speaker’s bureau of Roche, Pfizer, MSD, Angelini, Nordic Pharma, Advanz pharma, Bio-Merieux, Abbvie, Sanofi-Aventis, Medtronic and DiaSorin. AR has participated in advisory boards sponsored by Alexion Pharma Italy. MA has received honoraria by Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag, Merck Sharp & Dohme, Viiv Healthcare and has received study grants from Merck Sharp & Dohme. MG, FC, ML, SM, LM, VN declare no conflict of interest

Additional information

Funding

This study was supported by un unconditional grant by Angelini Pharma S.p.A.