DOTS Journal Club
New JAMA DOTS study (2025) finds dalbavancin as a potential IV-therapy alternative with results similar to standard therapy for S. aureus bacteremia
The Journal of the American Medical Association (JAMA) published the DOTS study online before print in August 2025. This post is a journal club breaking down the DOTS trial and what change it may bring to our clinical practice.
Background/Overview
Title: Dalbavancin for Treatment of Staphylococcus aureus Bacteremia
Citation: Turner NA, Jamasaki T, Doernberg SB, et al. Dalbavancin for Treatment of Staphylococcus aureus Bacteremia. JAMA. August 2025;334(10):866-877.
Objective: To evaluate the efficacy and safety of dalbavancin vs standard therapy for completion of treatment of complicated S. aureus bacteremia.
- Note: Standard therapy will be abbreviated as SOC for "standard of care" in this article
Background:
- Staph aureus is the leading cause of bacterial death due to bloodstream infections worldwide.
- Treatment typically required long-course intravenous (IV) antibiotics, which can be doses once a day and up to multiple times a day.
- Dalbavancin has a long half-life of 14 days. Dosing of dalbavancin is 1500 mg IV every 2 weeks.
- There is only one randomized trial and several case series assessing dalbavancin for S. aureus bacteremia at the time of the DOTS trial.
Primary Efficacy Measure: