Overview

• The NIH-supported Phase IIb DOTS trial enrolled 200 adults at 23 U.S. and Canadian centers, comparing two 1,500 mg IV doses of dalbavancin on days 1 and 8 against 4–8 weeks of daily IV antibiotics
• The probability of a superior overall outcome with dalbavancin was 47.7%, falling short of superiority while delivering similar clinical success and microbiological clearance rates
• Adverse events leading to treatment discontinuation occurred in 3% of dalbavancin patients versus 12% with standard therapy, and catheter-related complications were reduced in the dalbavancin group
• Open-label design and exclusion of high-risk populations—such as those with central nervous system involvement or left-sided endocarditis—limit generalization to broader patient cohorts
• Investigators are now analyzing cost-effectiveness and urging insurers to cover long-acting lipoglycopeptides as a validated alternative for selected Staph bloodstream infection cases