Projected health-service cost impact of dalbavancin consolidation therapy for Staphylococcus aureus bacteraemia in an Australian public health system.

Authors

Eli Dunn, Yolande Lindsay, Ian Marr, Fabian Chiong

Published in

Internal medicine journal. Jul 30, 2026. Epub Jul 30, 2026.

Abstract

Management of Staphylococcus aureus bacteraemia (SAB) requires prolonged intravenous (IV) antibiotic therapy delivered in hospital or through Hospital in the Home (HITH), often requiring peripherally inserted central catheters (PICCs) and substantial healthcare resources. Dalbavancin offers a consolidation strategy following blood-culture clearance that may reduce health-service utilisation. Australian data describing the economic implications of this approach remain limited.
We aimed to estimate the potential health-service cost impact of dalbavancin consolidation therapy for SAB within an Australian public healthcare setting.
We conducted a retrospective audit of adult patients with laboratory-confirmed SAB managed through HITH within Canberra Health Services between June 2023 and July 2024. Patients were stratified according to duration of IV therapy delivered via HITH (≤14 days vs >14 days). Based on comparable efficacy demonstrated in the Dalbavancin as an Option for Treatment of S. aureus (DOTS) randomised trial, a cost-minimisation framework compared observed costs of standard IV therapy with projected costs under a dalbavancin consolidation model.
Forty-one patients were included (12 ≤ 14 days; 29 > 14 days). Median HITH length of stay was 10 and 28 days respectively. Median per-patient total cost under standard IV therapy was AU$6313.98 (≤14 days) and AU$17 668.00 (>14 days). Projected dalbavancin strategy costs were AU$5646.00 and AU$11 827.00. Median per-patient cost differences favoured dalbavancin by AU$667.98 in the ≤14-day cohort and AU$5841.00 in the >14-day cohort. PICC placement occurred in 36 patients receiving standard therapy with five PICC-related complications recorded; PICCs were not required under the projected dalbavancin strategy.
Within an Australian public healthcare setting, dalbavancin consolidation therapy for selected patients with SAB was projected to reduce per-patient resource utilisation, particularly among those requiring prolonged HITH therapy. Reduced HITH bed utilisation and avoidance of central venous access were the principal contributors.

PMID:
42531603
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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