Dalbavancin for Treatment of Staphylococcus aureus Bacteremia

作者：Nicholas Turner, Toshimitsu Hamasaki, Sarah B. Doernberg, Thomas P. Lodise, Heather A. King, Varduhi Ghazaryan, Sara E. Cosgrove, Timothy C Jenkins, Catherine Liu, Shrabani Sharma, Smitha Zaharoff, Lana Wahid, Valerie J. Renard, Paul Cook, Issam Raad, Ray Hachem, Anne‐Marie Chaftari, Matthew Sims, Carmen DeMarco, Loren G. Miller, Matthew W. McCarthy, Caryn G. Morse, Christopher Lucasti, Graeme N. Forrest, Kartikeya Cherabuddi, Christopher Polk, Tasaduq Fazili, Mark E. Rupp, George R. Thompson, Kami Kim, Luke Strnad, Amanda E. Schnee, James A. McKinnell, Mayur Ramesh, Fernanda P. Silveira, Todd P McCarty, Todd C. Lee, Emily G. McDonald, Kristopher Paolino, Katie Wiegand, Alison Wall, Todd Riccobene, Rinal Patel, Urania Rappo, Scott Evans, Henry F. Chambers, Vance G. Fowler, Thomas L Holland, Antibacterial Resistance Leadership Group, Henry F. Chambers, Scott Evans, Vance G. Fowler, Toshimitsu Hamasaki, Robin Patel, H. R. Cross, Anthony Harris, Melinda M. Pettigrew, David van Duin, Helen W. Boucher, Clayton C. Huntley, Lanling Zou, Erica L. Raterman, Tamika Samuel, Kyung Ho Moon, Kimberly E. Hanson, Yohei Doi, Thomas L Holland, Thomas P. Lodise, Samuel A. Shelburne, Ritu Banerjee, Sara E. Cosgrove, David L. Paterson, Ebbing Lautenbach, Maureen Mehigan, Sarah B. Doernberg, S Perdue, John H. Beigel, David J. Roach, Tara A. Singh, Cathy Wickward, David A. Souto, Jason Waller · 发表于：JAMA · 年份：2025 · DOI：10.1001/jama.2025.12543 · 被引用次数：43 · 研究领域：Antimicrobial Resistance in Staphylococcus、Orthopedic Infections and Treatments、Bacterial Infections and Vaccines

Importance: Dalbavancin is a long-acting intravenous lipoglycopeptide that may be effective for treatment of complicated Staphylococcus aureus bacteremia without requiring long-term intravenous access. Objective: To evaluate the efficacy and safety of dalbavancin vs standard therapy for completion of treatment of complicated S aureus bacteremia. Design, Setting, and Participants: Open-label, assessor-masked, randomized clinical trial conducted from April 2021 to December 2023 at 23 medical centers in the US (n = 22) and Canada (n = 1). Participant follow-up lasted 70 days (180 days for participants with osteomyelitis); date of final follow-up was December 1, 2023. Hospitalized adults with complicated S aureus bacteremia who achieved blood culture clearance following at least 72 hours but no more than 10 days of initial antibacterial therapy were included. Participants were excluded if they had central nervous system infection, retained infected prosthetic material, left-sided endocarditis, or severe immune compromise. Interventions: Participants were randomly assigned to receive either 2 doses of intravenous dalbavancin (n = 100; 1500 mg on days 1 and 8) or 4 to 8 total weeks of standard intravenous therapy (n = 100; cefazolin or antistaphylococcal penicillin if methicillin susceptible; vancomycin or daptomycin if methicillin resistant). Main Outcomes and Measures: The primary outcome was the desirability of outcome ranking (DOOR) at day 70, which involved 5 components (clini...