Under what circumstance would you order dalbavancin instead of vancomycin or daptomycin for MRSA endocarditis?
The short answer is active/recent IV drug use. Personally, I don’t or didn’t agree with not using PICC and 6 weeks of daily IV abx. My understanding, although it may be outdated, is that there is evidence that most patients would not abuse the PICC. That had been my experience, I had only one patien...
I consider dalbavancin as an option in all types of MRSA endocarditis in any patient, but in particular, right-sided endocarditis. I based this practice on the DOTS randomized trial.
In our practice, we consider dalbavancin as an alternative to vancomycin or daptomycin for treating MRSA endocarditis in clinically stable patients who are unable or unwilling to complete the standard 6-week course of intravenous therapy, especially among people who inject drugs.