Vancomycin remains the mainstay therapy for methicillin-resistant S. aureus (MRSA) bloodstream infection (BSI), although daptomycin and ceftaroline may improve patient outcomes.

Study endpoints separate clinical outcomes and safety metrics and fail to provide comprehensive patient-centered comparisons of alternative therapies.

The desirability of outcomes ranking (DOOR) methodology ordinally ranks combinations of clinical and safety outcomes in mutually exclusive categories to determine overall probability of better outcome with one therapy versus another.

Infectious diseases experts have developed and validated a consensus-based DOOR for S. aureus BSI. This current study adjusted this DOOR for specific anti-MRSA therapies and applied it to a retrospective cohort of patients with MRSA BSI.

In this proof-in-concept cohort study, treatment of MRSA BSI with daptomycin or ceftaroline was associated with a 92% probability of overall better patient outcomes compared to treatment with vancomycin.