Is Dalbavancin Tx for Complicated S aureus Bacteremia Superior to Standard Care?

Background: Staphylococcus aureus bacteremia often requires weeks of intravenous (IV) therapy, which carries risks related to long-term venous access. Dalbavancin, a long-acting lipoglycopeptide with an approximately 14-day half-life, offers a 2-dose alternative that could simplify treatment once bacteremia has cleared. Objective: To examine whether dalbavancin is superior to standard IV therapy for completion of treatment of complicated S aureus bacteremia. Design: Open-label, assessor-masked, randomized clinical trial conducted at 23 centers in the United States and Canada (April 2021 to December 2023). Participants/Methods: Adults with complicated S aureus bacteremia or right-sided endocarditis were randomized after blood culture clearance following 3 to 10 days of initial therapy. Follow-up was 70 days (180 days for osteomyelitis). The primary end point was desirability of outcome ranking (DOOR), an end point integrating safety, efficacy, and quality of life, designed and validat more...