Abstract
BackgroundDelafloxacin 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.MethodsA 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.ResultsA 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.ConclusionsDelafloxacin 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.
Highlights
Complicated skin and soft tissue infections, or complicated skin and skin structure infections, represent a severe form of skin infections involving the skin and deeper soft tissues [1]. cSSSI have been associated with increasing morbidity, mortality and healthcare costs in recent decades [1, 2]
Delafloxacin is a promising new antibiotic for Acute bacterial skin and skin structure infections (ABSSSI) demonstrating greater improvement compared to ceftobiprole, fusidic acid, iclaprim, telavancin and vancomycin and comparable effectiveness versus standard of care for all outcomes considered in the study
In 2018, epidemiological data from 30 participating countries in the European Antimicrobial Resistance Surveillance (EARS) network and European Centre for Disease prevention and Control (ECDC) estimated that methicillin-resistant S. aureus (MRSA) accounted for 16.4% of all S. aureus isolates, with significant differences in national MRSA percentages ranging from 0% in Iceland to 43% in Romania [9]
Summary
Complicated skin and soft tissue infections (cSSTI), or complicated skin and skin structure infections (cSSSI), represent a severe form of skin infections involving the skin and deeper soft tissues [1]. cSSSI have been associated with increasing morbidity, mortality and healthcare costs in recent decades [1, 2]. In 2013, the US Food and Drug Administration (FDA) distinctly defined a subset of severe skin infections as acute bacterial skin and skin structure infections (ABSSSI) to facilitate the clinical development of drugs and evaluate efficacy of novel antibiotics through quantifiable variables such as lesion size and systemic signs of infections [4, 5]. 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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
