
    slow accrual of participants
  
['bacteremia due to staphylococcus aureus']
['daptomycin', 'vancomycin']

        Inclusion Criteria:

          -  Age > 21 years.

          -  Inpatient at the time of enrolment.

          -  MRSA bacteremia due to MRSA isolates with a vancomycin MIC > 1.5 ug/ml.

          -  Be prepared to undergo all treatments and procedures, and attend follow-ups as per the
             trial protocol.

        Exclusion Criteria:

          -  Allergy to any of the study medications.

          -  Pregnant or breastfeeding females.

          -  Unable to provide consent or have no legally authorized representatives.

          -  Currently enrolled or within the past three months participated in an interventional
             antibiotic or vaccine trial.

          -  >48 hours after MRSA vancomycin MIC > or equal to1.5 ug/ml confirmation by the
             microbiology laboratory (assessed from time of lab report).

          -  Patients on palliative care or with less than 24 hours of life expectancy (as
             discussed with their primary physicians).

          -  Polymicrobial bacteremia [see (a) below].

          -  Pneumonia [see (b) below].

          -  On treatment with linezolid, tigecycline or ceftaroline immediately prior to
             enrolment.

          -  Previous blood cultures positive for MRSA in the preceding one month.

          -  On vancomycin or daptomycin treatment for more than 96 hours prior to enrolment.

          -  BSI due to MRSA with vancomycin MIC > or equal to 4 ug/ml.

          -  Baseline serum creatine kinase more than 1.5 times the upper limit of normal.

          -  Patients with prosthetic heart valves

          -  Any other significant condition that would, in the opinion of the investigator,
             compromise the patient's safety or outcome in the trial.

               1. .Isolation of a significant organism other than MRSA from index blood cultures or
                  blood cultures taken up to two weeks prior to enrolment and/or for which the
                  patient is still on treatment.

               2. .Chest x-ray at baseline consistent with pneumonia AND at least 2 of the
                  following signs and symptoms: New onset or worsening cough, purulent sputum or
                  increased suctioning requirements, dyspnea/tachypnea or respiratory rate >
                  30/min, hypoxemia or worsening gas exchange as determined by study investigator.)
      