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Biotech / Medical : Biotech Valuation -- Ignore unavailable to you. Want to Upgrade?

To: Biomaven who wrote (10015)	1/14/2004 9:58:55 AM
From: quidditch	Read Replies (1) \| Respond to of 52153

I have to (uninvited) jump in here, as a veteran of a seven-week course of Vanco during 2000 following ACL reconstruction surgery at the Hospital for Special Surgery, following which I developed an infection at one of the scope sites. (Note: my ACL involved taking a section of my hamstring muscle and drilling holes through the tibia to attach one end of the "reconstructed" acl--hence the possibility of bone infection). In the course of the initial bacterial analysis (member of staff family), set-up for home (self) administration of the vanco, twice daily as per MICU's PR, repeated visits to the HSS deep tissue/bone infection specialist (quite good in his field) and our very active, probing discussions (I was worried), I learned a bit about this area generally. First, the once-a-week administration vs. 2x daily factor is huge, not solely because of the convenience/expense aspect. Vanco must be administered iv in highly viscous solution and can not usually be given in the normal wrist catheter. If you are going to be on vanco for long-term therapy (i.e. for deep tissue/bone infection) your course of therapy will be from four to eight weeks (mine was cut short by a week because I had to fly to Australia in 9/2000) and viscosity of vanco requires insertion of a pic line, performed by the radiology dep't (line in major vein in upper arm, runs into your vc do the solution goes into a wide artery with high volume flow--wrist catheter won't do it). Again because of the viscosity and the narrow entry diameter of the pic line, it frequently becomes blocked, in whole or in part, interfering with the vanco administration. The vanco protocol requires 2X daily at 12-hour intervals and patients are counseled to maintain this rigorously. A blockage of the pic line that can throw off more than one administration is ng, and I had to go to the ER twice to clear the line. In sum, the "hidden costs" related to vanco administration--which include the cost of the home care cottage industry that delivers vanco on a weekly basis to your home--refrigerated--and administers a weekly blood test to ascertain whether kidney enzymes are out of whack (a common side effect) are very, very significant. As to the 50% efficacy for CR-BSI, Peter, I am out of my depth here. But my understanding of the protocol for using vanco (which is still referred to by hospital personnel as the gold standard and treatment of last resort--obviously not quite accurate) is that its most prescribed use is for deep tissue and bone involvement, not necessarily blood stream. I don't know if that should make a difference. I have no position in MICU. But my knowledge of the vanco world, fwiw, did make me very interested in oritavancin. (:--( quid