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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05137119
Registration number
NCT05137119
Ethics application status
Date submitted
25/04/2021
Date registered
30/11/2021
Date last updated
5/06/2024
Titles & IDs
Public title
Staphylococcus Aureus Network Adaptive Platform Trial
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Scientific title
Staphylococcus Aureus Network Adaptive Platform Trial
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Secondary ID [1]
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CT19029
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Universal Trial Number (UTN)
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Trial acronym
SNAP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Staphylococcus Aureus Bacteremia
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Condition category
Condition code
Infection
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Other infectious diseases
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Blood
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Other blood disorders
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Infection
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Cefazolin
Treatment: Drugs - Penicillin
Treatment: Drugs - Clindamycin
Treatment: Drugs - Vancomycin
Other interventions - Effectiveness of early switch to oral antibiotics
Treatment: Other - Whole body FDG PET/CT Imaging
No intervention: Methicillin-resistant staphylococcus aureus (MRSA) - Standard Therapy Arm (backbone therapy) - Vancomycin or Daptomycin - Standard Therapy Arm
Either intravenous vancomycin dosed as per Australian Therapeutic Guidelines: This includes a loading dose of 25 mg/kg (up to 3000mg) if considered appropriate by the treating clinician, initial maintenance dosing at 15-20 mg/kg q12h, with subsequent adjustment to maintain area under the concentration-time curve (AUC) of 400 to 600 mg.hr/L OR trough levels at 10-20 mg/L, and the initial level taken 48-72 hours after the initiation of the first dose. Daptomycin 8-10mg/kg per day intravenously. The choice of vancomycin or daptomycin will be at the clinician's discretion. Dosing will be based on renal function.
Experimental: Methicillin-resistant staphylococcus aureus (MRSA) - Standard + B-Lactam Arm (backbone therapy) - Vancomycin or Daptomycin (Standard Therapy) + Beta-Lactam (ß-lactam) Arm
In addition to standard treatment an intravenous ß-lactam will be added for the first 7 calendar days following randomisation (day 1 being the day of randomisation - hence patients will receive 6-7 days of ß-lactam). This ß-lactam will be intravenous cefazolin 2g every 8 hours. For patients with renal impairment the intravenous cefazolin administration doses will be adjusted.
No intervention: Methicillin-susceptible staphylococcus aureus (MSSA) - Standard Therapy Arm (backbone therapy) - Flucloxacillin or cloxacillin - Standard Therapy Arm
Either intravenous flucloxacillin/cloxacillin 2g every 4 or 6 hours. The minimum protocol duration of allocated study treatment is 14 days for those not allocated to early oral switch, and 5 days for those allocated to early oral switch. For patients with renal impairment or critical illness the intravenous flucloxacillin administration dose will be adjusted.
Experimental: Methicillin-susceptible staphylococcus aureus (MSSA) - Interventional Arm (backbone therapy) - Cefazolin - Interventional Arm
Intravenous cefazolin 2g every 6 or 8 hours. The minimum protocol duration of allocated study treatment is 14 days for those not allocated to early oral switch, and 5 days for those allocated to early oral switch. For patients with renal impairment or critical illness the intravenous cefazolin administration dose will be adjusted.
No intervention: Penicillin-susceptible staphylococcus aureus (PSSA) - Standard Therapy Arm (backbone therapy) - Flucloxacillin or cloxacillin - Standard Therapy Arm
Either intravenous flucloxacillin/cloxacillin 2g every 4 or 6 hours. The minimum protocol duration of allocated study treatment is 14 days for those not allocated to early oral switch, and 5 days for those allocated to early oral switch. For patients with renal impairment or critical illness the intravenous flucloxacillin administration dose will be adjusted.
Experimental: Penicillin-susceptible staphylococcus aureus (PSSA) - Interventional Arm (backbone therapy) - Benzylpenicillin - Interventional Arm
Intravenous benzylpenicillin 1.8g (3 million units) every 4 or 6 hours. The minimum protocol duration of allocated study treatment is 14 days for those not allocated to early oral switch, and 5 days for those allocated to early oral switch. For patients with critical illness the intravenous benzylpenicillin administration doses will be adjusted.
No intervention: No adjunctive treatment in combination with MRSA or MSSA or PSSA backbone therapy arm - No adjunctive therapy + backbone therapy arm for MRSA or MSSA or PSSA
Participants with either MRSA or MSSA or PSSA will have no adjunctive therapy in combination with their backbone therapy arm.
Experimental: Adjunctive treatment in combination with MRSA or MSSA or PSSA backbone therapy arm - Adjunctive therapy + backbone therapy arm for MRSA or MSSA or PSSA Intravenous clindamycin (or lincomycin) 600mg every 8 hours from platform day 1 to day 5. No dosage adjustment is needed to renal impairment.
No intervention: Continue intravenous antibiotic therapies (backbone +/- adjunctive therapy) - standard of care arm - Backbone therapy arm for MRSA or MSSA or PSSA +/- adjunctive therapy will continue on intravenous antibiotic treatment for the length of time as per usual standard of care.
Participants eligibility is assessed at Day 7 (+/- 2 days) if eligible will be randomised if not eligible then eligibility will be assess again at Day 14(+/- 2 days). If eligibility is not met at day 14 then participant is excluded from this domain.
Experimental: Switch to oral antibiotics at trial day 7 (+/- 2 days) or Day 14 (+/- 2 days) if eligible. - Switch from intravenous backbone antibiotic for MRSA or MSSA or PSSA to oral antibiotics at the treating clinicians discretion on trial Day 7 (+/- 2 days) or trial Day 14 (+/- 2 days).
Participants eligibility is assessed at Day 7 (+/- 2 days). If eligible will be randomised, if not eligible then eligibility will be assessed again at Day 14 (+/- 2 days). If eligibility is not met at day 14 then participant is excluded from this domain.
No intervention: No PET/CT scan - standard of care arm - Participants will not receive a PET/CT scan, in addition to their allocated treatment interventions.
Participants eligibility is assessed at Day 7 (+/- 2 days) if eligible will be randomised. If eligibility is not met then participant is excluded from this domain.
Experimental: PET/CT scan at trial day 7 (+/- 2 days) if eligible - Participant will receive a PET/CT scan at Day 5-12, in addition to their allocated treatment interventions.
Participants eligibility is assessed at Day 7 (+/- 2 days) if eligible will be randomised. If eligibility is not met then participant is excluded from this domain.
Treatment: Drugs: Cefazolin
Cefazolin
Treatment: Drugs: Penicillin
benzylpenicillin
Treatment: Drugs: Clindamycin
Clindamycin
Treatment: Drugs: Vancomycin
Vancomycin or Daptomycin
Other interventions: Effectiveness of early switch to oral antibiotics
This involves testing a strategy rather than individual antibiotic agents
Treatment: Other: Whole body FDG PET/CT Imaging
Whole body FDG PET/CT imaging will be performed using a standardised protocol describing patient preparation and minimum specifications for radiopharmaceutical production, quality control, and PET/CT acquisition.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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Intervention code [3]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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All-cause mortality at 90 days after platform entry
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Assessment method [1]
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The primary endpoint for all cells and domains will be all-cause mortality at 90 days after platform entry.
The primary endpoint will be determined through a search of hospital databases for a record of a participant's death, or follow-up contact with the participant's community healthcare provider, or follow-up contact with the patient or their nominated carer, or linkage with death registries.
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Timepoint [1]
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From randomisation (day 1) until day 90
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Secondary outcome [1]
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All-cause mortality at 14, 28 and 42 days after platform entry
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Assessment method [1]
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Determined through a search of hospital databases for a record of a participant's death, or follow-up contact with the participant's community healthcare provider, or follow-up contact with the patient or their nominated carer, or linkage with death registries.
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Timepoint [1]
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From randomisation (day 1) until day 14, 28, and 42
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Secondary outcome [2]
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Duration of survival censored at 90 days after platform entry
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Assessment method [2]
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Determined through a search of hospital databases for a record of a participant's death, or follow-up contact with the participant's community healthcare provider, or follow-up contact with the patient or their nominated carer, or linkage with death registries.
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Timepoint [2]
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From randomisation (day 1) until day 90
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Secondary outcome [3]
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Length of stay of acute index inpatient hospitalisation for those surviving until discharge from acute inpatient facilities (excluding HITH/COPAT/OPAT/rehab).
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Assessment method [3]
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Acute index hospitalisation is defined as continuous hospital admission to one or more acute inpatient facilities for the index episode. This does not include HITH/OPAT/COPAT and stepdown inpatient rehabilitation/post-acute care. It does include admission to acute care hospitals immediately preceding and following those at the enrolling site.
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Timepoint [3]
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From randomisation (day 1) until discharge from acute inpatient facilities, truncated at 90 days.
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Secondary outcome [4]
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Length of stay of total index hospitalisation for those surviving until hospital discharge (including HITH/COPAT/OPAT/rehab)
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Assessment method [4]
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Total index hospitalisation is defined as continuous hospital admission to one or more inpatient facilities for the index episode, including HITH/OPAT/COPAT and stepdown inpatient rehabilitation/post-acute care (if continuous with the initial inpatient admission).
It includes admission to acute care hospitals immediately preceding and following those at the enrolling site.
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Timepoint [4]
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From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days
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Secondary outcome [5]
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Time to being discharged alive from the total index hospitalisation (including HITH/COPAT/OPAT/rehab) truncated at 90 days after platform entry
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Assessment method [5]
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and all deaths within 90 days will be considered '90 days'
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Timepoint [5]
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From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days
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Secondary outcome [6]
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Microbiological treatment failure defined as positive sterile site culture for S. aureus [of the same silo as the index isolate between 14 and 90 days after platform entry).
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Assessment method [6]
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A sterile site means any sites deep to the skin and skin structures, including deep visceral and musculoskeletal abscesses that have been obtained in a sterile manner.
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Timepoint [6]
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From randomisation (day 1) until day 90
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Secondary outcome [7]
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Diagnosis of new foci between 14 and 90 days after platform entry.
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Assessment method [7]
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The presence of new foci will be determined by the site investigator and can incorporate clinical, radiological, microbiological and pathological findings.
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Timepoint [7]
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From randomisation (day 1) until day 90
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Secondary outcome [8]
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C. difficile diarrhoea as determined by a clinical laboratory in the 90 days following platform entry for participants =2 years of age.
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Assessment method [8]
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This means a stool submitted to a clinical laboratory has tested positive for C. difficile toxin or toxin gene.
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Timepoint [8]
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From randomisation (day 1) until day 90
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Secondary outcome [9]
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Number of participants with Serious adverse reactions (SARs) in the 90 days following platform entry
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Assessment method [9]
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SARs defined only as events that are attributable to one or more study interventions
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Timepoint [9]
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From randomisation (day 1) until day 90
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Secondary outcome [10]
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Health economic costs as detailed in the cost utility analysis appendix.
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Assessment method [10]
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Including hospital length of stay, readmissions, and patient employment status.
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Timepoint [10]
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From randomisation (day 1) until day 90
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Secondary outcome [11]
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Proportion of participants who have returned to their usual level of function at day 90.
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Assessment method [11]
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Determined by whether the modified functional bloodstream infection score (FBIS) remained the same or improved between baseline and 90 days after platform entry.
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Timepoint [11]
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From randomisation (day 1) until day 90
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Secondary outcome [12]
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Desirability of outcome ranking 1 (modified Antibiotic Resistance Leadership Group version)
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Assessment method [12]
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unable to insert modified ARLG table
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Timepoint [12]
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From randomisation (day 1) until day 90
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Secondary outcome [13]
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Desirability of outcome ranking 2 (SNAP version)
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Assessment method [13]
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unable to insert SNAP DOOR table
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Timepoint [13]
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From randomisation (day 1) until day 90
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Secondary outcome [14]
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Number of antibiotic days (IV and/or oral/enteral)
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Assessment method [14]
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All days on which any antibiotic dose is received should be counted - i.e. we are counting the number of whole or part days on which any antibiotics are received (not the number of defined daily doses of antibiotics). Topical, inhaled or other routes of administration besides IV or oral/enteral should not be counted.
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Timepoint [14]
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From randomisation (day 1) until day 90
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Secondary outcome [15]
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Days alive and free of antibiotics
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Assessment method [15]
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All antibiotics should be included, not only those intended for treatment of S. aureus bacteraemia. It also includes prophylactic dose antibiotics (e.g., prophylactic dose trimethoprim-sulfamethoxazole)
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Timepoint [15]
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From randomisation (day 1) until day 90
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Eligibility
Key inclusion criteria
PLATFORM
Patients must fulfil all of the following criteria to be eligible to enter the SNAP trial:
1. Staphylococcus aureus complex grown from =1 blood culture
2. Admitted to a participating hospital at the time of eligibility assessment
PLATFORM
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Potentially eligible participants meeting any of the following criteria at the time of eligibility assessment for platform entry will be excluded from the trial:
1. Time of anticipated platform entry is greater than 72 hours post collection of the index blood culture. Where the time of culture collection is not recorded, the time of laboratory registration of the sample will be used as an alternative
2. Polymicrobial bacteraemia, defined as more than one organism (at species level) in the index blood cultures OR in any subsequent blood culture reported between the collection of the index blood culture and platform eligibility assessment, excluding those organisms judged to be contaminants by either the microbiology laboratory or treating clinician.
3. Known previous participation in the randomised SNAP platform
4. Known positive blood culture for S. aureus (of the same silo: PSSA, MSSA or MRSA) between 72 hours and 180 days prior to the time of eligibility assessment
5. Treating team deems enrolment in the study is not in the best interest of the patient
6. Treating team believes that death is imminent and inevitable
7. Patient is for end-of-life care and antibiotic treatment is considered not appropriate
8. Patient <18 years of age and paediatric recruitment not approved at recruiting site
9. Patient has died since the collection of the index blood culture
To be included in any of the following DOMAINS the participant must met eligible for the PLATFORM (as listed above)
ADJUNCTIVE TREATMENT DOMAIN
Inclusion Criteria:
1. All participants that met the PLATFORM eligible are eligible to be included in this domain unless they meet any of the following exclusions listed.
2. Patients are eligible for this domain regardless of S. aureus susceptibility testing results to clindamycin.
Exclusion criteria:
1. Previous type 1 hypersensitivity reaction to lincosamides 2. Currently receiving clindamycin (lincomycin) or linezolid which cannot be ceased or substituted 3. Necrotising fasciitis 4. Current C. difficile associated diarrhoea (any severity) 5. Current severe diarrhoea from any cause (defined as Grade 3 or higher) 5. Known CDAD (C.Difficile Associated Diarrhoea) in the past 3 months, or CDAD relapse in the past 12 months 6. At the time of domain eligibility assessment, more than 4 hours has elapsed since platform entry 7. Treating clinician deems enrolment in this domain is not in the best interest of the patient
PSSA, MSSA TREATMENT DOMAIN (backbone)
Inclusion Criteria:
1. For PSSA silo: Index blood culture is penicillin-susceptible as per phenotypic disc testing with EUCAST (a P1 disc diffusion with a feathered zone >=26mm) OR CLSI (a P10 disc diffusion) defined criteria
2. For MSSA silo: Index blood culture isolate is methicillin-susceptible but penicillin resistant
Exclusion Criteria (PSSA & MSSA):
1. >72 hours have elapsed since the collection of the index blood culture (i.e. the time of collection of the first positive blood culture from the patient during this episode)
2. History of type I hypersensitivity reaction (i.e. anaphylaxis or angioedema) to any penicillin or cephalosporin
3. History of severe delayed reaction (e.g. allergic interstitial nephritis, cutaneous vasculitis, Stevens-Johnson, DRESS, etc.) to any penicillin or cephalosporin
4. PSSA silo: Non-severe rash to any penicillin (unless patient has been subsequently de-labelled; this criteria does not include criteria 2 and 3 above), or MSSA silo: Non-severe rash to cefazolin or any penicillin (unless patient has been subsequently de-labelled) (Nausea, diarrhoea, headache, and other non-specific symptoms are NOT allergies, they are drug intolerance, and they are not exclusion criteria. Similarly, a vague history of an allergy of unclear nature, or a family history of allergy are not exclusions.)
5. Treating team deems enrolment in this domain is not in the best interest of the patient
6. Currently receiving maintenance dialysis (haemodialysis or peritoneal dialysis) (Acute renal replacement therapy (including CRRT, haemodialysis or peritoneal dialysis) are not exclusions. Such patients are eligible as long as appropriate vascular access is available or can be arranged.)
7. Polymicrobial bacteraemia (defined as more than one organism [at species level] in blood cultures, excluding those organisms judged to be contaminants by either the microbiology laboratory or treating clinician) reported between collection of the index blood culture and backbone domain eligibility assessment
8. Patient currently being treated with a systemic antibacterial agent that cannot be ceased or substituted for interventions allocated within the platform (unless antibiotic is listed in Table 1 of the DSA, which specifies allowed antibiotics with limited absorption from the gastrointestinal tract or negligible antimicrobial activity against S. aureus)
MRSA TREATMENT DOMAIN (backbone)
Inclusion Criteria:
1. MRSA confirmed microbiologically
1. Time to allocation reveal is >72 hours from time of index blood culture collection
2. Severe allergy to any beta-lactam (including cefazolin) Immediate severe allergy: Anaphylaxis/angioedema Severe delayed allergy: Severe cutaneous adverse reaction (SCAR; including Steven Johnson Syndrome, Toxic Epidermal Necrolysis, Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) and acute generalised exanthematous pustulosis (AGEP)), severe drug induced liver injury, proven allergic interstitial nephritis, immune-mediated haemolytic anaemia and other severe cytopenia.
3. Non-severe rash to cefazolin Nausea, diarrhoea, headache and other non-specific symptoms are NOT allergies, they are drug intolerance, and they are not exclusion criteria. Similarly, a vague history of an allergy of unclear nature, or a family history of allergy are not exclusions.)
3. Severe allergy or non-severe rash to both vancomycin AND daptomycin Vancomycin infusion reaction (formerly known as "red man syndrome") is due to direct histamine release and is not generally an allergy, and therefore is not considered an exclusion.
5. Treating team deems enrolment in the domain is not in the best interest of the patient 6. Polymicrobial bacteraemia (defined as more than one organism [at species level] in blood cultures, excluding those organisms judged to be contaminants by either the microbiology laboratory or treating clinician) reported between collection of the index blood culture and backbone domain eligibility assessment.
7. Patient currently being treated with a systemic antibacterial agent that cannot be ceased or substituted for interventions allocated within the platform (unless antibiotic is listed in Table 1 of the DSA, which specifies allowed antibiotics with limited absorption from the gastrointestinal tract or negligible antimicrobial activity against S. aureus)
EARLY ORAL SWITCH DOMAIN
Inclusion Criteria:
Day 7 (+/- 2 days):
1. Clearance of SAB by platform Day 2: blood cultures negative for S. aureus from platform Day 2 onwards AND no known subsequent positive blood cultures
2. Afebrile (<37.8°C) for the past 72 hours (at time of judging eligibility)
3. Primary focus is either line related (either central or peripheral IV cannula) or skin and soft tissue, AND source control achieved (for 'line-related' this means line removed; for 'skin and soft tissue' means site PI considers source control to have been achieved and any abscess more than 2cm diameter has been drained)
4. No evidence of metastatic foci (on clinical or radiological examination, but radiological imaging is not required to exclude metastatic foci if not clinically indicated)
Day 14 (+/- 2 days):
1. Clearance of SAB by platform Day 5: blood cultures negative for S. aureus from platform Day 5 (+/-1 day) AND no known subsequent positive blood cultures. If the most recent blood culture from Day 2-4 is negative for S. aureus, blood cultures do not need to be repeated on Day 5 to fulfil eligibility criteria (Day 5 blood cultures will be assumed to be negative in this situation)
2. Afebrile (<37.8°C) for the past 72 hours (at time of judging eligibility)
3. Site Principal Investigator has determined that source control is adequate
When judging eligibility at platform Day 7 (+/- 2 days) and at Day 14 (+/- 2 days), exclusion criteria are:
1. Adherence to oral agents unlikely (as judged by site PI in consultation with the treating team)
2. Unreliable gastrointestinal absorption (e.g. vomiting, diarrhoea, nil by mouth, anatomical reasons)
3. There are no appropriate oral antibiotics due to contraindications, drug availability, or antibiotic resistance
4. Ongoing IV therapy unsuitable e.g. no IV access
5. Clinician deems not appropriate for early oral switch
6. Patient no longer willing to participate in domain In the lead-up to judging eligibility, it may be helpful to discuss with the patient the potential for continued IV treatment versus oral switch, to allow hospital discharge planning
7. Clinical team deems that sufficient duration of antibiotic therapy has already been provided
Exclusions when judging eligibility for early oral switch at trial Day 7 (+/- 2 days):
1. Presence of prosthetic cardiac valve, pacemaker or other intracardiac implant
2. Presence of intravascular clot, graft, or other intravascular prosthetic material Intravascular clot excludes superficial peripheral IV line-related thrombophlebitis. Intravascular prosthetic material excludes coronary artery stents)
3. Intravascular/intracardiac infections (e.g. endocarditis, mycotic aneurysm)
4. Presence of other intracardiac abnormalities felt to put patient at increased risk of endocarditis (e.g., bicuspid aortic valve)
PET/CT DOMAIN
Inclusion Criteria:
1. PET/CT participating site
2. Patient is accessible for PET/CT - a patient is considered accessible if the site team are able to access the participant medical records, arrange for a PET/CT scan for the patient, and discuss this domain with the patient and their treating healthcare providers.
1. Pregnant - patients of childbearing potential should be assessed for pregnancy status and a pregnancy test performed (if not performed within the past 10 days)
2. Currently breastfeeding
3. < 18 years of age
4. Patient has had PET/CT in the past 7 days
5. Patient needs PET/CT in the next 7 days (in the opinion of the clinical team, at the time of eligibility assessment)
6. Clinically unstable for PET/CT (as judged by the treating clinical team, taking into account need for organ support (including inotropes) and capacity to lie flat for the PET/CT)
7. Contraindication to PET/CT (e.g., claustrophobia, persistently elevated blood sugar levels [>12.5mmol/L] that cannot be corrected).
8. Patient no longer willing to participate in the domain - in the days leading up to judging eligibility, it may be helpful to discuss with the patient the potential for PET/CT vs no PET/CT to allow imaging planning
9. Clinician deems participation in this domain is not in the patient's best interests
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/02/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2028
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Actual
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Sample size
Target
8000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
Australia Capital TerritoryNSW,NT,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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Canberra Hospital - Garran
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Recruitment hospital [2]
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Blacktown Hospital - Blacktown
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Recruitment hospital [3]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [4]
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Concord Repatriation and General Hospital - Concord
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Recruitment hospital [5]
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St Vincent's Hospital Sydney - Darlinghurst
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Recruitment hospital [6]
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Nepean Hospital - Kingswood
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Recruitment hospital [7]
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St George Hospital - Kogarah
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Recruitment hospital [8]
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Liverpool Hospital - Liverpool
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Recruitment hospital [9]
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John Hunter Hospital - New Lambton Heights
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Recruitment hospital [10]
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John Hunter Children's Hospital - Newcastle
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Recruitment hospital [11]
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Orange Health Service - Orange
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Recruitment hospital [12]
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Prince of Wales Hospital - Randwick
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Recruitment hospital [13]
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Sydney Children's Hospital - Randwick
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Recruitment hospital [14]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [15]
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Westmead Hospital - Westmead
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Recruitment hospital [16]
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Wollongong Hospital - Wollongong
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Recruitment hospital [17]
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Royal Darwin Hospital - Tiwi
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Recruitment hospital [18]
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Sunshine Coast University Hospital - Birtinya
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Recruitment hospital [19]
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Cairns Hospital - Cairns
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Recruitment hospital [20]
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Royal Brisbane and Women's Hospital - Herston
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Recruitment hospital [21]
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Ipswich Hospital - Ipswich
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Recruitment hospital [22]
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Logan Hospital - Meadowbrook
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Redcliffe Hospital - Redcliffe
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Recruitment hospital [24]
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Robina Hospital - Robina
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Recruitment hospital [25]
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [26]
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Gold Coast University Hospital - Southport
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Recruitment hospital [27]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [28]
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Lyell McEwin Hospital - Adelaide
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Recruitment hospital [29]
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [30]
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Women and Children's Hospital - North Adelaide
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Recruitment hospital [31]
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Women's and Children's Hospital - North Adelaide
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Recruitment hospital [32]
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Royal Hobart Hospital - Hobart
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Recruitment hospital [33]
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Launceston Hospital - Launceston
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Recruitment hospital [34]
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Grampians Health - Ballarat
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Recruitment hospital [35]
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Bendigo Health - Bendigo
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Recruitment hospital [36]
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Box Hill Hospital - Box Hill
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Royal Children's Hospital Melbourne - Parkville
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6000 - Perth
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6112 - Perth
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Funding & Sponsors
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University of Melbourne
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Berry Consultants
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McGill University Health Centre/Research Institute of the McGill University Health Centre
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Menzies School of Health Research
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Aotearoa Clinical Trials
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Queensland University of Technology
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Tan Tock Seng Hospital
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Telethon Kids Institute
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Radboud University Medical Center
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King's College London
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Rambam Health Care Campus
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University College, London
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Houston Medical Research Institute
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Ethics approval
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Summary
Brief summary
The Staphylococcus aureus Network Adaptive Platform (SNAP) trial is an International Multi-Centered Randomised Adaptive Platform Clinical Trial to evaluate a range of interventions to reduce mortality for patients with Staphylococcus Aureus bacteraemia (SAB).
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Trial website
https://clinicaltrials.gov/study/NCT05137119
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Trial related presentations / publications
Tong SYC, Mora J, Bowen AC, Cheng MP, Daneman N, Goodman AL, Heriot GS, Lee TC, Lewis RJ, Lye DC, Mahar RK, Marsh J, McGlothlin A, McQuilten Z, Morpeth SC, Paterson DL, Price DJ, Roberts JA, Robinson JO, van Hal SJ, Walls G, Webb SA, Whiteway L, Yahav D, Davis JS; Staphylococcus aureus Network Adaptive Platform (SNAP) Study Group. The Staphylococcus aureus Network Adaptive Platform Trial Protocol: New Tools for an Old Foe. Clin Infect Dis. 2022 Nov 30;75(11):2027-2034. doi: 10.1093/cid/ciac476. Erratum In: Clin Infect Dis. 2023 Apr 17;76(8):1532-1533. doi: 10.1093/cid/ciac730. Symons TJ, Straiton N, Gagnon R, Littleford R, Campbell AJ, Bowen AC, Stewart AG, Tong SYC, Davis JS. Consumer perspectives on simplified, layered consent for a low risk, but complex pragmatic trial. Trials. 2022 Dec 28;23(1):1055. doi: 10.1186/s13063-022-07023-z. Malhame I, Hardy E, Cheng MP, Tong SY, Bowen AC. Walking the walk to include pregnant participants in non-obstetric clinical trials: Insights from the SNAP Trial. Obstet Med. 2023 Mar;16(1):3-4. doi: 10.1177/1753495X231163351. Epub 2023 Mar 22. No abstract available. Henderson A, Cheng MP, Chew KL, Coombs GW, Davis JS, Grant JM, Gregson D, Giulieri SG, Howden BP, Lee TC, Nguyen V, Mora JM, Morpeth SC, Robinson JO, Tong SYC, Van Hal SJ; Microbiology Working Group of the Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Group. A multi-site, international laboratory study to assess the performance of penicillin susceptibility testing of Staphylococcus aureus. J Antimicrob Chemother. 2023 Jun 1;78(6):1499-1504. doi: 10.1093/jac/dkad116. de Kretser D, Mora J, Bloomfield M, Campbell A, Cheng MP, Guy S, Hensgens M, Kalimuddin S, Lee TC, Legg A, Mahar RK, Marks M, Marsh J, McGlothlin A, Morpeth SC, Sud A, Ten Oever J, Yahav D, Tong SY, Davis JS, Walls G, Goodman AL, Bonten M; Staphylococcus aureus Network Adaptive Platform (SNAP) Study Group members. Early oral antibiotic switch in Staphylococcus aureus bacteraemia: The Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Early Oral Switch Protocol. Clin Infect Dis. 2023 Oct 31:ciad666. doi: 10.1093/cid/ciad666. Online ahead of print. Mahar RK, McGlothlin A, Dymock M, Lee TC, Lewis RJ, Lumley T, Mora J, Price DJ, Saville BR, Snelling T, Turner R, Webb SA, Davis JS, Tong SYC, Marsh JA; SNAP Global Trial Steering Committee. A blueprint for a multi-disease, multi-domain Bayesian adaptive platform trial incorporating adult and paediatric subgroups: the Staphylococcus aureus Network Adaptive Platform trial. Trials. 2023 Dec 6;24(1):795. doi: 10.1186/s13063-023-07718-x.
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Public notes
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Contacts
Principal investigator
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Prof Steven Tong
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University of Melbourne / Melbourne Health
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Contact person for public queries
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Lauren Barina
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0
+61 (03) 8344 1623
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0
[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
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Results not provided in
https://clinicaltrials.gov/study/NCT05137119
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