Objective:

To evaluate the relationship between dalbavancin exposure and clinical success in adults with complicated Staphylococcus aureus bacteremia.

Key Findings:

• 72 out of 93 evaluable patients (77%) achieved clinical success at day 70.
• Patients with concentrations >32 μg/mL had a success rate of 97% compared to 68% for those with ≤32 μg/mL.
• Higher AUC values were associated with improved outcomes, but did not reach statistical significance.

Interpretation:

The findings suggest a potential link between higher dalbavancin exposure and improved clinical outcomes, but causality cannot be established due to the observational nature of the analysis.

Limitations:

• Exposure was not randomized, limiting causal inference.
• Findings may not generalize to patients with early treatment failure or more severe illness.
• Exploratory nature of exposure threshold definition increases risk of spurious findings.

Conclusion:

Sustained dalbavancin exposure may be important for preventing late complications of S aureus bacteremia, warranting further investigation into dosing strategies.