Dalbavancin vs standard of care for Staphylococcus aureus bacteraemia in patients unable to receive outpatient parenteral antimicrobial therapy

Background: This study compared dalbavancin with standard of care (SOC) for patients with Staphylo-coccus aureus bacteraemia (SAB) who were unable to receive outpatient parenteral antimicrobial therapy (OPAT).Methods: This retrospective cohort compared re-admission rates related to the index infection between patients treated with dalbavancin or SOC for SAB. Patients aged & GE;18 years seen by the infectious diseases consult service who had received at least one dose of dalbavancin or at least 1 week of SOC parenteral antibacterials as directed therapy for SAB at the time of discharge were included. The SOC group con-sisted of patients transferred from the main hospital to one of the post-acute care facilities to complete parenteral antibacterials. The primary outcome was re-admission rate within 30 days of completion of therapy. Secondary outcomes included re-admission rate within 90 days of completion of therapy and adherence to the antibacterial regimen.Results: Twenty-seven patients received dalbavancin and 27 patients received SOC. Baseline demograph-ics were comparable between groups, although more patients in the SOC group had indwelling prosthe-ses or hardware (4% vs 22%). The majority of SAB was caused by methicillin-susceptible S. aureus (56% vs 59%). Re-admission rates for the dalbavancin group were similar to those for the SOC group within 30 days (15% vs 22%; P = 0.484) and 90 days (19% vs 22%; P = 0.735) of completion of therapy. Adherence to the antibacterial regimen was significantly higher among patients treated with dalbavancin compared with SOC (85% vs 44%; P < 0.001).Conclusions: Dalbavancin offers similar clinical outcomes to SOC for patients with SAB who are unable to receive OPAT.& COPY; 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.