A recent study led by Duke Health researchers indicates that a two-dose antibiotic regimen may be as effective as traditional long-term intravenous therapy for treating serious staph bloodstream infections. The research, funded by the National Institutes of Health, compared the antibiotic dalbavancin to standard care, which involves antibiotics administered through a peripherally inserted central catheter (PICC line).
The results, published in the Journal of the American Medical Association (JAMA), suggest that dalbavancin given in two doses one week apart can eliminate the infection while reducing risks associated with PICC lines. These risks include limited mobility, blood clots, and additional infections. Traditional treatment typically requires weeks of specialized nursing care at home or in hospital settings.
“Staph bloodstream infections are among the most common and most deadly infections we see in hospitals,” said Nicholas Turner, M.D., first author of the study and assistant professor in the Department of Medicine at the Duke University School of Medicine. “Even with antibiotics that technically kill the bacteria, one in four patients can still die. That’s why we need better, easier treatments.”
The study enrolled 200 adult patients with severe staph bloodstream infections. After initial hospital care, participants were randomly assigned to receive either standard IV antibiotics over four to six weeks or two doses of dalbavancin spaced one week apart. Researchers monitored infection cure rates and tracked complications or side effects using a patient-centered measure called DOOR (Desirability of Outcome Ranking).
Dalbavancin was found to be equally effective at curing infections and had slightly fewer side effects than standard therapy. The simplified regimen also lessened the need for home health visits and lab monitoring.
“This study expands the treatment options for patients and their doctors,” said Thomas Holland, M.D., corresponding author and professor in the Department of Medicine at Duke University School of Medicine. “Dalbavancin offers a way to complete therapy without the hassle and hazards of long-term IV access. That’s a meaningful shift in how we care for people with serious infections.”
Researchers noted that dalbavancin could be especially useful for vulnerable populations who may face challenges with long-term IV therapy. A cost-effectiveness analysis is ongoing to evaluate broader impacts on healthcare systems due to reduced hospitalization times when using dalbavancin.
Duke University Hospital is located in Durham, North Carolina and was founded in 1925. It serves as both a treatment center—with over 41,000 patient admissions reported in 2022—and a training hospital under its current president Craig T. Albanese.
The study included contributions from numerous co-authors across various institutions and received funding from the National Institute of Allergy and Infectious Diseases under NIAID Award No. 5UM1Al104681.
