Early oral antibiotic switch in Staphylococcus aureus bacteraemia : The Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Early Oral Switch Protocol
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
BACKGROUND: Staphylococcus aureus bloodstream infection (bacteraemia) is traditionally treated with at least two weeks of IV antibiotics in adults, 3-7 days in children, and often longer for those with complicated disease. The current practice of treating S. aureus bacteraemia (SAB) with prolonged IV antibiotics (rather than oral antibiotics) is based on historical observational research and expert opinion. Prolonged IV antibiotic therapy has significant disadvantages for patients and healthcare systems, and there is growing interest in whether a switch to oral antibiotics following an initial period of IV therapy is a safe alternative for clinically stable patients.
PROTOCOL: The early oral switch (EOS) domain of the S. aureus Network Adaptive Platform (SNAP) trial will assess early switch to oral antibiotics compared with continued IV treatment in clinically stable patients with SAB. The primary endpoint is 90-day all-cause mortality. Hospitalised SAB patients are assessed at platform day 7 +/- 2 (uncomplicated SAB) and day 14 +/-2 (complicated SAB) to determine their eligibility for randomisation to EOS (intervention) or continued IV treatment (current standard of care).
DISCUSSION: Recruitment is occurring to the EOS domain of the SNAP trial. As of August 2023, 21% of all SNAP participants had been randomised to the EOS domain, a total of 264 participants across 77 centres, with an aim to recruit at least 1000 participants. We describe challenges and facilitators to enrolment in this domain to aid those planning similar trials.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - (2023) vom: 31. Okt. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Kretser, Dana [VerfasserIn] |
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| Links: |
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| Themen: |
Adaptive platform |
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| Anmerkungen: |
Date Revised 03.11.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/cid/ciad666 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a de Kretser, Dana |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early oral antibiotic switch in Staphylococcus aureus bacteraemia |b The Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Early Oral Switch Protocol |
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| 500 | |a Date Revised 03.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a BACKGROUND: Staphylococcus aureus bloodstream infection (bacteraemia) is traditionally treated with at least two weeks of IV antibiotics in adults, 3-7 days in children, and often longer for those with complicated disease. The current practice of treating S. aureus bacteraemia (SAB) with prolonged IV antibiotics (rather than oral antibiotics) is based on historical observational research and expert opinion. Prolonged IV antibiotic therapy has significant disadvantages for patients and healthcare systems, and there is growing interest in whether a switch to oral antibiotics following an initial period of IV therapy is a safe alternative for clinically stable patients | ||
| 520 | |a PROTOCOL: The early oral switch (EOS) domain of the S. aureus Network Adaptive Platform (SNAP) trial will assess early switch to oral antibiotics compared with continued IV treatment in clinically stable patients with SAB. The primary endpoint is 90-day all-cause mortality. Hospitalised SAB patients are assessed at platform day 7 +/- 2 (uncomplicated SAB) and day 14 +/-2 (complicated SAB) to determine their eligibility for randomisation to EOS (intervention) or continued IV treatment (current standard of care) | ||
| 520 | |a DISCUSSION: Recruitment is occurring to the EOS domain of the SNAP trial. As of August 2023, 21% of all SNAP participants had been randomised to the EOS domain, a total of 264 participants across 77 centres, with an aim to recruit at least 1000 participants. We describe challenges and facilitators to enrolment in this domain to aid those planning similar trials | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a S. aureus | |
| 650 | 4 | |a Staphylococcus aureus | |
| 650 | 4 | |a adaptive platform | |
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| 650 | 4 | |a bloodstream infection | |
| 650 | 4 | |a clinical trial | |
| 650 | 4 | |a intravenous antibiotic | |
| 650 | 4 | |a oral antibiotic | |
| 650 | 4 | |a parenteral therapy | |
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| 700 | 1 | |a Bloomfield, Max |e verfasserin |4 aut | |
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| 700 | 1 | |a Cheng, Matthew P |e verfasserin |4 aut | |
| 700 | 1 | |a Guy, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Hensgens, Marjolein |e verfasserin |4 aut | |
| 700 | 1 | |a Kalimuddin, Shirin |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Todd C |e verfasserin |4 aut | |
| 700 | 1 | |a Legg, Amy |e verfasserin |4 aut | |
| 700 | 1 | |a Mahar, Robert K |e verfasserin |4 aut | |
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| 700 | 1 | |a Marsh, Julie |e verfasserin |4 aut | |
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| 700 | 1 | |a Morpeth, Susan C |e verfasserin |4 aut | |
| 700 | 1 | |a Sud, Archana |e verfasserin |4 aut | |
| 700 | 1 | |a Ten Oever, Jaap |e verfasserin |4 aut | |
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| 700 | 1 | |a Goodman, Anna L |e verfasserin |4 aut | |
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| 700 | 1 | |a Heriot, George S |e investigator |4 oth | |
| 700 | 1 | |a Lewis, Roger J |e investigator |4 oth | |
| 700 | 1 | |a Lye, David C |e investigator |4 oth | |
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| 700 | 1 | |a Paterson, David L |e investigator |4 oth | |
| 700 | 1 | |a Robinson, J Owen |e investigator |4 oth | |
| 700 | 1 | |a Roberts, Jason A |e investigator |4 oth | |
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| 700 | 1 | |a Whiteway, Lynda |e investigator |4 oth | |
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