{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:43:53Z","timestamp":1792640633245,"version":"4.5.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1AI104681"],"award-info":[{"award-number":["UM1AI104681"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Dalbavancin as an Option for the Treatment of S. aureus bacteremia (DOTS) trial demonstrated similar clinical outcomes among 200 adults with complicated Staphylococcus aureus bacteremia (SAB) randomized to 2 doses of dalbavancin or standard-therapy antibiotics after initial clearance. We aimed to determine whether the higher cost of dalbavancin is offset through reductions in medical resource use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used dates for hospitalizations and antibiotics from the trial starting from randomization. Antibiotic costs were based on generic pricing for dalbavancin and most other antibiotics. Medicare payment rates were used to estimate costs for scenarios representing home-based or clinic-based outpatient parenteral antibiotic therapy (OPAT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On average, patients randomized to dalbavancin spent 2.2 fewer SAB-related days in the hospital (95% confidence interval [CI], \u22125.3 to 1.3) and received antibiotics on 24.4 fewer days (95% CI, \u221229.0 to \u221219.9). Mean inpatient costs for SAB-related admissions were lower by $5805 (95% CI, \u2212$14 311 to $3390) in the dalbavancin group. Antibiotic drug costs were $2343 higher (95% CI, $1728\u2013$3027), but OPAT costs were lower with dalbavancin by $2469 (95% CI, \u2212$2913 to \u2212$1970) in the home-based scenario and $1112 (95% CI, \u2212$1289 to \u2212$914) in the clinic-based scenario. Net costs for SAB-related care were $5931 lower (95% CI, \u2212$14 660 to $3004) and $4574 lower (95% CI, \u2212$13 312 to $4335) with dalbavancin versus standard therapy with home-based and clinic-based OPAT, respectively. Among patients with injection drug use (IDU), savings with dalbavancin were approximately $22 000.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>On average, savings from reduced inpatient care and less OPAT fully offset the higher cost of dalbavancin in patients with SAB. Savings were greater in patients with IDU.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. NCT04775953.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag567","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:13:23Z","timestamp":1789384403000},"source":"Crossref","is-referenced-by-count":1,"title":["Economic Outcomes of Dalbavancin Versus Standard Therapy in\n                    <i>Staphylococcus aureus<\/i>\n                    Bacteremia in the Dalbavancin as an Option for the Treatment of\n                    <i>S. aureus<\/i>\n                    Bacteremia (DOTS) Randomized Clinical Trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7654-4464","authenticated-orcid":false,"given":"Shelby D","family":"Reed","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]},{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Li","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0650-4894","authenticated-orcid":false,"given":"Nicholas A","family":"Turner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6686-7844","authenticated-orcid":false,"given":"Dana K","family":"Pasquale","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0406-0804","authenticated-orcid":false,"given":"Richard","family":"Drew","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]},{"name":"Campbell University College of Pharmacy and Health Sciences Department of Pharmacy Practice, , Buies Creek, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cook","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Brody School of Medicine, East Carolina University , Greenville, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smitha","family":"Zaharoff","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8048-0897","authenticated-orcid":false,"suffix":"Jr","given":"Vance G","family":"Fowler","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-9010","authenticated-orcid":false,"given":"Thomas L","family":"Holland","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine 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