Table 2.

Priorities and Opportunities for Gram-Positive Infections

Unmet Need	Category
Topic: Staphylococci
Prospective evaluation of strategies to diagnose MRSA colonization as a way to risk-stratify need for MRSA antibiotic therapy for common infectious syndromes	Diagnosis
Comparative efficacy, safety, and tolerability of oral antibiotics for invasive Staphylococcus aureus infections	Treatment
Defining the role of combination therapy with β-lactams for MRSA and methicillin-resistant CoNS BSIs	Treatment
Defining optimal management of persistent MRSA BSI	Treatment
Defining comparative efficacy and safety of intravenous agents other than vancomycin for MRSA and methicillin-resistant CoNS BSIs	Treatment
Defining the efficacy and safety of adjunctive therapies such as immunotherapeutics	Treatment
Adequacy of oral vs parenteral therapy for osteomyelitis	Treatment
Safety and efficacy of step-down therapy for osteomyelitis	Treatment
Comparative efficacy and safety of regimens with and without adjunctive rifampin for vertebral osteomyelitis	Treatment
Topic: Enterococci
Approaches to prevention of VRE colonization and infection	Prevention
Defining subgroups of patients who are at high risk of failing a particular therapy	Diagnosis
Comparative efficacy and safety of linezolid vs daptomycin for VRE BSI	Treatment
Role of combination therapy with β-lactams for enterococcal BSI and osteomyelitis	Treatment
Role of combination therapy with β-lactams against VRE	Treatment
Defining the optimal length of therapy for VRE BSI	Treatment
Optimal therapy for VRE endocarditis	Treatment
Optimal therapy for VRE with high daptomycin MIC	Treatment
Topic: Clostridium difficile infection
Impact of testing approaches on rates of infection and individual outcomes	Diagnosis
Development and impact of ultra-sensitive toxin-detection tests	Diagnosis
Better elucidation of complex relationships in the inpatient and outpatient setting contributing to CDI	Prevention
Microbiome-related strategies for secondary prevention of CDI	Prevention
Vaccine development	Prevention
Microbiome-related strategies for secondary prevention of CDI	Prevention
Microbiome-related strategies for treatment of mild, moderate, and severe CDI	Treatment
Colon-sparing surgical approaches for management of severe/complicated CDI	Treatment
Topic: New gram-positive antibiotics
Dosing, efficacy, safety, and impact on resistance of oritavancin and dalbavancin for follow-on therapy for resistant infections	Treatment
Safety and efficacy of tedizolid for longer-term use	Treatment
Topic: Group A Streptococcus
Efficacy of intravenous immunoglobulin for treatment of severe, invasive infections	Treatment

Abbreviations: BSI, bloodstream infection; CDI, Clostridium difficile infection; CoNS, coagulase-negative staphylococci; MIC, minimum inhibitory concentration; MRSA, methicillin-resistant Staphylococcus aureus; VRE, vancomycin-resistant enterococci.