Two-Dose Antibiotic Offers New Hope for Treating Deadly Staph Infections
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DURHAM, N.C. – A new study shows that a simplified two-dose antibiotic treatment may be just as effective as traditional long-term IV therapy for serious staph (staphylococcus) bloodstream infections, offering patients a safer and easier path to recovery.
Led by researchers at Duke Health and funded by the National Institutes of Health, the study tested the antibiotic dalbavancin against the standard of care – antibiotics delivered through a peripherally inserted central catheter (or PICC line).
The findings suggest that dalbavancin, given in two doses a week apart, can treat the infection without the risks and burdens of a PICC line, which often requires weeks of specialized nursing care at home or in the hospital and is associated with risks such as limited mobility, blood clots, and additional infections.
The study is published in the Journal of the American Medical Association (JAMA). Duke researchers said the results are significant given how prevalent and dangerous staph infections can be.
“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.”
To conduct the study, researchers enrolled 200 adult patients with severe staph bloodstream infections. After initial hospital care, patients were randomly assigned to receive either standard IV antibiotics over 4–6 weeks or two doses of dalbavancin spaced one week apart. The team tracked not only whether the infection was cured, but also any complications or side effects along the way using a patient-centered measure called DOOR (Desirability of Outcome Ranking).
Dalbavancin performed equally well in curing infections and had slightly fewer side effects. The simplified regimen also reduced the need for home health visits, lab monitoring, and the risks associated with PICC lines, making it especially promising for patients with limited support or higher risk of complications.
“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 the 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.”
The researchers note that dalbavancin may be particularly beneficial for vulnerable populations. A cost-effectiveness analysis is underway to assess broader healthcare system impacts associated with the reduced hospitalizations times dalbavancin allows.
In addition to Turner and Holland, study authors include 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, LanaWahid, 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, Chris Lucasti, Graeme N. Forrest, Kartikeya Cherabuddi, Christopher Polk, Tasaduq Fazili, Mark E. Rupp, George R. Thompson III, 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, AlisonWall, Todd Riccobene, Rinal Patel, Urania Rappo, Scott Evans, Henry F. Chambers, and Vance G. Fowler Jr.
The research was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under NIAID Award No. 5UM1Al104681.