JAMA Netw Open

Are long-acting lipoglycopeptides a feasible alternative to standard care for serious infections?

June 4, 2025

Study details: A large comparative effectiveness study emulating a target trial used U.S. Cerner Real World Data (2015–2022) to evaluate outcomes in 42,067 adults discharged after hospitalization for serious gram-positive bacterial infections (bacteremia, endocarditis, osteomyelitis, septic arthritis). Patients receiving long-acting lipoglycopeptides (laLGPs; dalbavancin or oritavancin) were compared with those on standard-of-care (SOC) antibiotics, with analyses stratified by persons who use drugs (PWUD) status. Primary outcome was a composite of 90-day readmission, ED visit, or inpatient death/discharge to hospice.

Results: Among 825 laLGP recipients (2.0%), there was no statistically significant difference in the composite outcome compared with SOC in both PWUD (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.88–1.13) and non-PWUD (HR, 0.93; 95% CI, 0.86–1.00) groups.

Clinical impact: LaLGPs may offer a viable alternative to SOC antibiotics for step-down therapy in serious gram-positive infections, particularly benefiting patients with barriers to prolonged IV therapy or outpatient adherence. Their use may facilitate early discharge and reduce healthcare resource utilization without compromising outcomes.

Source:

Goodman-Meza D, et al. (2025, May 21). JAMA Netw Open. Comparative Effectiveness of Long-Acting Lipoglycopeptides vs Standard-of-Care Antibiotics in Serious Bacterial Infections. https://pubmed.ncbi.nlm.nih.gov/40397442/