Successful treatment of Enterococcus faecalis bacteremia with dalbavancin as an outpatient in an intravenous drug user

This report describes the treatment of a 35-year-old male who presented to the emergency department with an empyema, and who had a long hospital course complicated by a catheter-related bloodstream infection and a history of intravenous drug use. Blood culture results confirmed Enterococcus faecalis. He was not a candidate for outpatient intravenous therapy and needed 14 days of treatment, but was able to be discharged with a 3-day supply of oral levofloxacin to complete treatment for his empyema and 1 dose of dalbavancin at an outpatient infusion center to treat his bacteremia. Due to the unique properties of dalbavancin, off-label use in specific populations may help facilitate transitions of care. This report outlines the successful use of dalbavancin and removal of the central catheter in the treatment of E. faecalis bacteremia.