SHM Converge Scientific Abstract ePoster Gallery-Dalbavancin Pathway to Shorten Stays: A Multidisciplinary Model for Mrsa/Mssa Bacteremia Requiring Prolonged Iv Therapy

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Northwell Health is New York State’s largest health care provider and private employer, committed to high-quality care, education, research, and community service regardless of ability to pay.<br /><br />This document describes a multidisciplinary dalbavancin pathway designed to shorten hospital stays for patients with MRSA or MSSA bacteremia who traditionally require 4–6 weeks of IV antibiotics. Standard treatment often creates discharge barriers because it requires PICC lines, lab monitoring, outpatient infusion access, and is especially difficult for patients with intravenous drug use, limited resources, or insurance challenges.<br /><br />Dalbavancin is a long-acting antibiotic that covers common bloodstream infection pathogens and can be given weekly, allowing eligible patients to complete therapy without a central line. The pathway uses shared decision-making and coordinated review by a clinical pharmacist, infectious disease physician, and hospitalist leadership to identify appropriate candidates. Patients receive 1,500 mg IV at discharge, with a possible second 1,500 mg dose on day 7 arranged through the emergency department. Follow-up labs and surveillance cultures are monitored collaboratively.<br /><br />In a small implementation group of six patients, the pathway avoided 119 excess hospital days and produced an estimated $37,500 in savings. Reported outcomes were strong: 0 readmissions, 0 mortality, 0 treatment complications, and 100% infection resolution. Additional benefits included improved patient satisfaction, reduced PICC-related risk, and less monitoring burden.<br /><br />The team plans to expand the pathway across more hospitals, develop formal eligibility criteria, increase ED infusion capacity, and study its use in other prolonged IV therapy conditions such as osteomyelitis, endocarditis, and complicated skin or soft tissue infections.

Asset Subtitle

Rishi Malhan

Meta Tag

Author List Bryant Faria, Janette Hernandez-Torres, Joseph Eskandrous, Kasia HILLS Gejdel, Miriam Smith, Rishi Malhan, Sangam B. Jhaveri

Category Innovations

Concept Long-Acting Lipoglycopeptides

Concept MRSA Bacteremia

Concept MSSA Bacteremia

Concept Long-Acting Intravenous Therapy

Concept Hospital Stay

Distinguished Non-Finalist

Presenter Organization Northwell Health

Presenting Author Rishi Malhan

Track Value in Hospital Medicine

Keywords

Northwell Health

dalbavancin

MRSA bacteremia

MSSA bacteremia

long-acting antibiotic

hospital discharge

PICC line avoidance

intravenous drug use

infection resolution

cost savings

Long-Acting Lipoglycopeptides

MRSA Bacteremia

MSSA Bacteremia

Long-Acting Intravenous Therapy

Hospital Stay