Staphylococcus Aureus Network Adaptive Platform Trial (SNAP)

April 29, 2026 updated by: University of Melbourne

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).

Study Overview

Status

Recruiting

Conditions

Staphylococcus Aureus Bacteremia

Intervention / Treatment

Detailed Description

Infection of the bloodstream with the bacterium Staphylococcus aureus (Staphylococcus aureus bacteraemia, SAB) is a serious infection that results in 15-30% of affected patients dying within three months of acquiring the infection. Treatment of this infection requires patients to be hospitalised, treated with prolonged antibiotics through an intravenous line, and carefully examined for the occurrence of complications associated with this condition. At present, there are many treatment options in current use, with no clear agreement as to which of these is best. The SNAP trial aims to identify which treatment options for SAB results in the fewest patients dying within the first 90 days after an infection.

In contrast to a conventional clinical trial, the SNAP trial will examine multiple different treatment options at once. Patients will be randomly assigned to different concurrent treatment options currently considered acceptable in routine medical care, but as the trial progresses, more patients will be assigned to treatments that appear to have better outcomes than those with worse outcomes. The trial will adapt to accumulating trial evidence, on a regular basis, by removing treatment options found to be inferior, incorporating new treatment options, and ensuring that all patients in the trial receive the best treatments once they have been identified. Over time, we hope to determine the best combination of treatment options for patients with SAB.

The SNAP Trial infrastructure will also support a number of sub-studies. A list of all active sub-studies can be found on the SNAP website: https://www.snaptrial.com.au/substudies.

Study Type

Interventional

Enrollment (Estimated)

8000

Phase

Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Lauren Barina
Phone Number: +61 (03) 8344 1623
Email: lauren.barina@unimelb.edu.au

Study Contact Backup

Name: Susan Goulding
Phone Number: +61 (03) 8344 7799
Email: susan.goulding@unimelb.edu.au

Study Locations

Australia
- Australia Capital Territory
  - Garran, Australia Capital Territory, Australia, 2605
    - Recruiting
    - Canberra Hospital
    - Principal Investigator:
      
      Heather Wilson
- New South Wales
  - Blacktown, New South Wales, Australia, 2148
    - Recruiting
    - Blacktown Hospital
    - Principal Investigator:
      
      Ravindra Dotel
  - Camperdown, New South Wales, Australia, 2050
    - Recruiting
    - Royal Prince Alfred Hospital
    - Principal Investigator:
      
      Sebastian VanHal
  - Concord, New South Wales, Australia, 2139
    - Recruiting
    - Concord Repatriation and General Hospital
    - Principal Investigator:
      
      Genevieve McKew
    - Sub-Investigator:
      
      Timothy Gray
  - Darlinghurst, New South Wales, Australia, 2010
    - Recruiting
    - St Vincent's Hospital Sydney
    - Principal Investigator:
      
      Gail Matthews
  - Kingswood, New South Wales, Australia, 2747
    - Recruiting
    - Nepean Hospital
    - Principal Investigator:
      
      Archana Sud
  - Kogarah, New South Wales, Australia, 2217
    - Not yet recruiting
    - St George Hospital
    - Principal Investigator:
      
      Katy Lai
  - Liverpool, New South Wales, Australia, 2170
    - Recruiting
    - Liverpool Hospital
    - Principal Investigator:
      
      Hong Foo
  - New Lambton Heights, New South Wales, Australia, 2305
    - Recruiting
    - John Hunter Hospital
    - Principal Investigator:
      
      Brian Chong
  - Newcastle, New South Wales, Australia, 2305
    - Recruiting
    - John Hunter Children's Hospital
    - Principal Investigator:
      
      Coen Butters
  - Orange, New South Wales, Australia, 2800
    - Recruiting
    - Orange Health Service
    - Principal Investigator:
      
      Jacob Williams
  - Randwick, New South Wales, Australia, 2031
    - Recruiting
    - Prince of Wales Hospital
    - Principal Investigator:
      
      Trine Gulholm
  - Randwick, New South Wales, Australia, 2031
    - Recruiting
    - Sydney Children's Hospital
    - Principal Investigator:
      
      Brendan McMullan
  - Westmead, New South Wales, Australia, 2145
    - Recruiting
    - Westmead Hospital
    - Principal Investigator:
      
      Matthew O'Sullivan
  - Westmead, New South Wales, Australia, 2145
    - Recruiting
    - The Children's Hospital at Westmead
    - Principal Investigator:
      
      Philip Britton
  - Wollongong, New South Wales, Australia, 2500
    - Recruiting
    - Wollongong Hospital
    - Principal Investigator:
      
      Niladri Ghosh
- Northern Territory
  - Tiwi, Northern Territory, Australia, 0811
    - Recruiting
    - Royal Darwin Hospital
    - Principal Investigator:
      
      Jane Davies
    - Sub-Investigator:
      
      Josh Francis
    - Sub-Investigator:
      
      Kate Proudmore
- Queensland
  - Birtinya, Queensland, Australia, 4575
    - Recruiting
    - Sunshine Coast University Hospital
    - Principal Investigator:
      
      David Sowden
    - Sub-Investigator:
      
      Shradha Subedi
  - Cairns, Queensland, Australia, 4870
    - Recruiting
    - Cairns Hospital
    - Principal Investigator:
      
      Simon Smith
  - Herston, Queensland, Australia, 4029
    - Recruiting
    - Royal Brisbane and Women's Hospital
    - Principal Investigator:
      
      Bridget Barber
  - Ipswich, Queensland, Australia, 4305
    - Recruiting
    - Ipswich Hospital
    - Principal Investigator:
      
      John Woodford
  - Meadowbrook, Queensland, Australia, 4131
    - Not yet recruiting
    - Logan Hospital
    - Principal Investigator:
      
      Vichitra Sukumaran
  - Redcliffe, Queensland, Australia, 4020
    - Recruiting
    - Redcliffe Hospital
    - Principal Investigator:
      
      Kevin O'Callaghan
  - Robina, Queensland, Australia, 4226
    - Recruiting
    - Robina Hospital
    - Principal Investigator:
      
      Peter Simos
  - South Brisbane, Queensland, Australia, 4101
    - Recruiting
    - Queensland Children's Hospital
    - Principal Investigator:
      
      Clare Nourse
  - Southport, Queensland, Australia, 4215
    - Recruiting
    - Gold Coast University Hospital
    - Principal Investigator:
      
      Peter Simos
  - Woolloongabba, Queensland, Australia, 4102
    - Not yet recruiting
    - Princess Alexandra Hospital
    - Principal Investigator:
      
      Andrew Henderson
- South Australia
  - Adelaide, South Australia, Australia, 5112
    - Recruiting
    - Lyell McEwin Hospital
    - Principal Investigator:
      
      Rory Hannah
  - Bedford Park, South Australia, Australia, 5042
    - Recruiting
    - Flinders Medical Centre
    - Principal Investigator:
      
      Nicholas Anagnostou
  - North Adelaide, South Australia, Australia, 5006
    - Not yet recruiting
    - Women's and Children's Hospital
    - Principal Investigator:
      
      Nan Vasilunas
  - North Adelaide, South Australia, Australia, 5006
    - Not yet recruiting
    - Women and Children's Hospital
    - Principal Investigator:
      
      Michael Stark
- Tasmania
  - Hobart, Tasmania, Australia, 7000
    - Not yet recruiting
    - Royal Hobart Hospital
    - Principal Investigator:
      
      Peter Leung
  - Launceston, Tasmania, Australia, 7250
    - Recruiting
    - Launceston Hospital
    - Principal Investigator:
      
      Ali Trad
- Victoria
  - Ballarat, Victoria, Australia, 3350
    - Recruiting
    - Grampians Health
    - Principal Investigator:
      
      Robert Commons
  - Bendigo, Victoria, Australia, 3550
    - Recruiting
    - Bendigo Health
    - Principal Investigator:
      
      Andrew Mahony
  - Box Hill, Victoria, Australia, 3128
    - Recruiting
    - Box Hill Hospital
    - Principal Investigator:
      
      Stephen Guy
  - Clayton, Victoria, Australia, 3168
    - Not yet recruiting
    - Monash Children's Hospital
    - Principal Investigator:
      
      Jeremy Carr
  - Clayton, Victoria, Australia, 3168
    - Recruiting
    - Monash Health - Monash Medical Centre & Jesse McPherson Private Hospital
    - Principal Investigator:
      
      Ben Rogers
  - Footscray, Victoria, Australia, 3011
    - Recruiting
    - Western Health - Footscray, Joan Kirner & Sunshine Hospitals
    - Principal Investigator:
      
      Adrian Tramontana
  - Frankston, Victoria, Australia, 3199
    - Not yet recruiting
    - Frankston Hospital
    - Principal Investigator:
      
      Kasha Singh
  - Geelong, Victoria, Australia, 3220
    - Recruiting
    - Barwon Health - University Hospital Geelong
    - Principal Investigator:
      
      Eugene Athan
  - Heidelberg, Victoria, Australia, 3084
    - Recruiting
    - Austin Hospital
    - Principal Investigator:
      
      Natasha Holmes
  - Melbourne, Victoria, Australia, 3004
    - Recruiting
    - Alfred Hospital
    - Contact:
      
      James McMahon
    - Principal Investigator:
      
      James McMahon
  - Parkville, Victoria, Australia, 3050
    - Recruiting
    - Royal Melbourne Hospital
    - Principal Investigator:
      
      Justin Denholm
  - Parkville, Victoria, Australia, 3052
    - Recruiting
    - Royal Children's Hospital Melbourne
    - Principal Investigator:
      
      Amanda Gwee
  - Shepparton, Victoria, Australia, 3630
    - Completed
    - Goulburn Valley Health
  - Traralgon, Victoria, Australia, 3844
    - Not yet recruiting
    - La Trobe Regional Hospital
    - Principal Investigator:
      
      Zaal Meher-Homji
- Western Australia
  - Murdoch, Western Australia, Australia, 6150
    - Recruiting
    - Fiona Stanley Hospital
    - Principal Investigator:
      
      Owen Robinson
  - Nedlands, Western Australia, Australia, 6009
    - Recruiting
    - Perth Children's Hospital
    - Principal Investigator:
      
      Asha Bowen
    - Sub-Investigator:
      
      Anita Campbell
  - Perth, Western Australia, Australia, 6000
    - Recruiting
    - Royal Perth Hospital
    - Principal Investigator:
      
      Owen Robinson
  - Perth, Western Australia, Australia, 6112
    - Recruiting
    - Armadale Hospital
    - Principal Investigator:
      
      David New
Canada
- Alberta
  - Calgary, Alberta, Canada, T3M 1M4
    - Recruiting
    - South Health Campus
    - Principal Investigator:
      
      Ranjani Somayaji
  - Calgary, Alberta, Canada, T1Y 6J4
    - Recruiting
    - Peter Lougheed Centre
    - Principal Investigator:
      
      Ranjani Somayaji
  - Calgary, Alberta, Canada, T2V 1P9
    - Recruiting
    - Rockyview Hospital
    - Principal Investigator:
      
      Ranjani Somayaji
  - Calgary, Alberta, Canada, T2N4Z6
    - Recruiting
    - Foothills Medical Center
    - Principal Investigator:
      
      Ranjani Somayaji
  - Edmonton, Alberta, Canada, T6G2B7
    - Recruiting
    - University of Alberta Hospital
    - Principal Investigator:
      
      Stephanie Smith
- British Columbia
  - Richmond, British Columbia, Canada, V6X1A2
    - Recruiting
    - Richmond Hospital
    - Principal Investigator:
      
      Clement Kwok
  - Surrey, British Columbia, Canada
    - Recruiting
    - Fraser Health Authority - Surrey Memorial Hospital
    - Principal Investigator:
      
      Kevin Afra
  - Vancouver, British Columbia, Canada, V5Z1M9
    - Recruiting
    - Vancouver General Hospital
    - Principal Investigator:
      
      Jennifer Grant
- Manitoba
  - Winnipeg, Manitoba, Canada, R2H 2A6
    - Recruiting
    - St. Boniface Hospital
    - Principal Investigator:
      
      Terry Wuerz
  - Winnipeg, Manitoba, Canada, R3J 3M7
    - Recruiting
    - Grace Hospital
    - Principal Investigator:
      
      Terry Wuerz
  - Winnipeg, Manitoba, Canada, R3A1R9
    - Recruiting
    - Health Sciences Centre Winnipeg
    - Principal Investigator:
      
      Terry Wuerz
- Newfoundland and Labrador
  - St. John's, Newfoundland and Labrador, Canada, A1B3V6
    - Recruiting
    - Eastern Health - Health Sciences Centre (Memorial University)
    - Principal Investigator:
      
      Peter Daley
  - St. John's, Newfoundland and Labrador, Canada
    - Recruiting
    - Eastern Regional Health Authority - St. Clare's Mercy Hospital
    - Principal Investigator:
      
      Peter Daley
- Ontario
  - East York, Ontario, Canada, M4C3E7
    - Recruiting
    - Toronto East Health Network - Michael Garron Hospital
    - Principal Investigator:
      
      Christopher Kandel
  - East York, Ontario, Canada, M5G2C4
    - Completed
    - University Health Network - Toronto General Hospital
  - Hamilton, Ontario, Canada
    - Recruiting
    - Hamilton Health Sciences - Juravinski Hospital
    - Principal Investigator:
      
      Dominik Mertz
  - Hamilton, Ontario, Canada, L8P1A2
    - Recruiting
    - Hamilton Health Sciences - Hamilton General Hospital
    - Principal Investigator:
      
      Dominik Mertz
  - Kingston, Ontario, Canada, K7L2V7
    - Recruiting
    - Kingston Health Sciences Centre - Kingston General Hospital
    - Principal Investigator:
      
      Anthony Bai
  - London, Ontario, Canada
    - Completed
    - London Health Sciences Centre - University Hospital, LHSC
  - Niagara Falls, Ontario, Canada
    - Recruiting
    - Niagara Health - Niagara Falls Site
    - Principal Investigator:
      
      David McCullagh
  - Ottawa, Ontario, Canada
    - Recruiting
    - The Ottawa Hospital - General Campus
    - Principal Investigator:
      
      Derek MacFadden
  - Ottawa, Ontario, Canada, K1H8L6
    - Recruiting
    - The Ottawa Hospital - Civic Campus
    - Principal Investigator:
      
      Derek MacFadden
  - Sault Ste. Marie, Ontario, Canada, P6B 0A8
    - Completed
    - Sault Area Hospital
  - St. Catharines, Ontario, Canada, L2S 0A9
    - Recruiting
    - Niagara Health - St. Catharines site
    - Principal Investigator:
      
      David McCullagh
  - Toronto, Ontario, Canada, M4N3M5
    - Recruiting
    - Sunnybrook Health Sciences Centre
    - Principal Investigator:
      
      Nick Daneman
  - Toronto, Ontario, Canada, M1L 1W1
    - Recruiting
    - Unity Health - St Michael's Hospital
    - Principal Investigator:
      
      Matthew Muller
  - Toronto, Ontario, Canada, M5G1X5
    - Recruiting
    - Sinai Heath System - Mount Sinai Hospital
    - Principal Investigator:
      
      Jennie Johnstone
  - Toronto, Ontario, Canada
    - Recruiting
    - Unity Health Toronto - St Joseph's Health Centre
    - Principal Investigator:
      
      Kevin Schwarz
  - Toronto, Ontario, Canada
    - Completed
    - University Health Network - Toronto Western Hospital
- Quebec
  - Laval, Quebec, Canada
    - Recruiting
    - CISSS - Hôpital Cité-de-la-Santé Hospital
    - Principal Investigator:
      
      Stephanie Castonguay
  - Montreal, Quebec, Canada, H3T1E2
    - Recruiting
    - Jewish General Hospital
    - Principal Investigator:
      
      Leighanne Parkes
  - Montreal, Quebec, Canada, H4A3J1
    - Recruiting
    - McGill University Health Centre - Montral General Hospital
    - Principal Investigator:
      
      Matthew Cheng
  - Montreal, Quebec, Canada
    - Not yet recruiting
    - McGill University Health Centre - Montreal Children's Hospital
    - Principal Investigator:
      
      Jesse Pappenburg
  - Montreal, Quebec, Canada
    - Recruiting
    - McGill University Health Centre - Royal Victoria Hospital
    - Principal Investigator:
      
      Matthew Cheng
  - Saint-Jérôme, Quebec, Canada, J7Z5T3
    - Recruiting
    - Hopital regional de saint jerome
    - Principal Investigator:
      
      Sébastien Poulin
  - Sherbrooke, Quebec, Canada, J1H 5H3
    - Recruiting
    - University of Sherbrooke Health Centre - Hospital Fleurimont
    - Principal Investigator:
      
      Francois Lamontagne
  - Sherbrooke, Quebec, Canada
    - Recruiting
    - University of Sherbrooke Health Centre - Hotel Dieu
    - Principal Investigator:
      
      Francois Lamontagne
France
- - Rennes, France
    - Recruiting
    - CHU de Rennes - Hôpital Pontchaillou
    - Principal Investigator:
      
      David Luque Paz
Germany
- - Berlin, Germany
    - Recruiting
    - Charité University Hospital Berlin
    - Principal Investigator:
      
      Miriam Stegemann
  - Dresden, Germany
    - Recruiting
    - University Hospital Carl Gustav Carus Dresden
    - Principal Investigator:
      
      Katja de With
  - Freiburg im Breisgau, Germany
    - Recruiting
    - University Medical Centre Freiburg
    - Principal Investigator:
      
      Siegbert Richard Rieg
  - Magdeburg, Germany
    - Recruiting
    - Otto-von-Guericke-university Magdeburg
    - Principal Investigator:
      
      Achim Kaasch
Israel
- - Haifa, Israel, 310960
    - Recruiting
    - Rambam Health Care Campus
    - Principal Investigator:
      
      Mical Paul
  - Petah Tikva, Israel
    - Recruiting
    - Schneider Hospital
    - Principal Investigator:
      
      Oded Scheureman
  - Petah Tikva, Israel, 49100
    - Recruiting
    - Beilinson Hospital
    - Principal Investigator:
      
      Noa Eliakim-Raz
  - Ramat Gan, Israel, 49100
    - Recruiting
    - Sheba Medical Centre
    - Principal Investigator:
      
      Dafna Yahav
Japan
- Chiba
  - Ichikawa, Chiba, Japan, 272-0827
    - Recruiting
    - Science Tokyo University Hospital
    - Contact:
      
      Principal Investigator Yoshiaki Gu
Netherlands
- - 's-Hertogenbosch, Netherlands
    - Recruiting
    - Jeroen Bosch Hospital
    - Principal Investigator:
      
      Thijs ten Doesschate
  - Arnhem, Netherlands
    - Active, not recruiting
    - Rijnstate Hospital
  - Emmen, Netherlands
    - Recruiting
    - Treant Ziekenhuis
    - Principal Investigator:
      
      Sander van Assen
  - Groningen, Netherlands
    - Active, not recruiting
    - UMC Groningen
  - Maastricht, Netherlands
    - Recruiting
    - Maastricht UMC+
    - Principal Investigator:
      
      Astrid Oude Lashof
  - Nieuwegein, Netherlands
    - Recruiting
    - Antonius Ziekenhuis
    - Principal Investigator:
      
      Bas Weijer
  - Nijmegen, Netherlands
    - Recruiting
    - Radboud University Medical Center
    - Principal Investigator:
      
      Nynke Jager
  - Rotterdam, Netherlands
    - Recruiting
    - Ikazia Ziekenhuis
    - Principal Investigator:
      
      Felix de Jongh
  - Utrecht, Netherlands
    - Recruiting
    - University Medical Center Utrecht
    - Principal Investigator:
      
      Marjolein Hensgens
New Zealand
- - Auckland, New Zealand, 1023
    - Recruiting
    - Starship Hospital
    - Principal Investigator:
      
      Rachel Webb
  - Auckland, New Zealand, 2025
    - Recruiting
    - KidzFirst
    - Principal Investigator:
      
      Rachel Webb
  - Hamilton, New Zealand, 3240
    - Recruiting
    - Waikato Hospital
    - Principal Investigator:
      
      Paul Huggan
  - Tauranga, New Zealand, 3112
    - Recruiting
    - Tauranga Hospital
    - Principal Investigator:
      
      Kate Grimwade
  - Whangarei, New Zealand, 0148
    - Not yet recruiting
    - Whangarei Hospital
    - Principal Investigator:
      
      David Hammer
- Auckland
  - Grafton, Auckland, New Zealand, 1023
    - Recruiting
    - Auckland City Hospital
    - Principal Investigator:
      
      Mark Hobbs
  - Otahuhu, Auckland, New Zealand, 1640
    - Recruiting
    - Middlemore Hospital
    - Principal Investigator:
      
      Genevieve Walls
    - Sub-Investigator:
      
      Rachel Webb
    - Sub-Investigator:
      
      Susan Morpeth
  - Takapuna, Auckland, New Zealand, 0620
    - Recruiting
    - North Shore Hospital
    - Principal Investigator:
      
      Nick Gow
- Canterbury
  - Christchurch, Canterbury, New Zealand, 8011
    - Not yet recruiting
    - Christchurch Hospital
    - Principal Investigator:
      
      Sarah Metcalf
- Lower Hutt
  - Boulcott, Lower Hutt, New Zealand, 5010
    - Recruiting
    - Hutt Valley Hospital
    - Principal Investigator:
      
      Matthew Kelly
- Wellington Region
  - Newtown, Wellington Region, New Zealand, 6021
    - Recruiting
    - Wellington Hospital
    - Principal Investigator:
      
      Max Bloomfield
Singapore
- - Singapore, Singapore, 308433
    - Recruiting
    - Tan Tock Seng Hospital
    - Principal Investigator:
      
      David Lye
  - Singapore, Singapore, 119228
    - Recruiting
    - National University Hospital
    - Principal Investigator:
      
      Sophia Archuleta
  - Singapore, Singapore, 168753
    - Recruiting
    - Singapore General Hospital
    - Principal Investigator:
      
      Shirin Kalimuddin
South Africa
- - Johannesburg, South Africa
    - Not yet recruiting
    - Charlotte Maxeke Johannesburg Academic Hospital
  - Johannesburg, South Africa
    - Not yet recruiting
    - Rahima Moosa Mother and Child Hospital
  - Johannesburg, South Africa
    - Active, not recruiting
    - Helen Joseph Hospital
Sweden
- - Helsingborg, Sweden
    - Recruiting
    - Helsingborg Hospital
    - Principal Investigator:
      
      Jonas Tverring
  - Malmö, Sweden
    - Recruiting
    - SUS Malmö
    - Principal Investigator:
      
      Maria Josephson
United Kingdom
- - Aberdeen, United Kingdom
    - Not yet recruiting
    - NHS Grampian
    - Principal Investigator:
      
      Robin Brittain-Long
  - Birmingham, United Kingdom
    - Recruiting
    - University Hospitals Birmingham
    - Principal Investigator:
      
      James Scriven
  - Brighton, United Kingdom
    - Recruiting
    - Brighton and Sussex University Hospitals
    - Principal Investigator:
      
      Sunil Sharma
  - Bristol, United Kingdom
    - Recruiting
    - North Bristol
    - Principal Investigator:
      
      Ed Moran
  - Bristol, United Kingdom
    - Recruiting
    - University Hospitals Bristol and Weston
    - Principal Investigator:
      
      Raje Dhillon
  - Cambridge, United Kingdom
    - Not yet recruiting
    - Cambridge University Hospitals
    - Principal Investigator:
      
      Theodore Gouliouris
  - Cardiff, United Kingdom
    - Recruiting
    - Cardiff and Vale University
    - Principal Investigator:
      
      Jonathan Underwood
  - Cornwall, United Kingdom
    - Not yet recruiting
    - Royal Cornwall Hospitals
    - Principal Investigator:
      
      Ollie Lloyd
  - Devon, United Kingdom
    - Not yet recruiting
    - Royal Devon University Healthcare
    - Principal Investigator:
      
      Rachel Patel
  - Dundee, United Kingdom
    - Not yet recruiting
    - NHS Tayside
    - Principal Investigator:
      
      Nikolas Rae
  - Edinburgh, United Kingdom
    - Recruiting
    - Lothian Western General
    - Principal Investigator:
      
      Rebecca Sutherland
  - Glasgow, United Kingdom
    - Not yet recruiting
    - Greater Glasgow and Clyde
    - Principal Investigator:
      
      Michael Murphey
  - Glasgow, United Kingdom
    - Not yet recruiting
    - NHS Golden Jubilee
    - Principal Investigator:
      
      Fiona Thornburn
  - Hull, United Kingdom
    - Recruiting
    - Hull University Teaching Hospitals
    - Principal Investigator:
      
      Nick Easom
  - Leeds, United Kingdom
    - Recruiting
    - Leeds Teaching Hospitals
    - Principal Investigator:
      
      Fiona McGill
  - Liverpool, United Kingdom
    - Recruiting
    - Liverpool University Hospital
    - Principal Investigator:
      
      Steve Aston
  - London, United Kingdom
    - Not yet recruiting
    - Kings College Hospital
    - Principal Investigator:
      
      Jasmin Isalm
  - London, United Kingdom
    - Recruiting
    - Imperial College Healthcare
    - Principal Investigator:
      
      Claire Waddlington
  - London, United Kingdom
    - Recruiting
    - University College London Hospitals
    - Principal Investigator:
      
      Michael Marks
  - London, United Kingdom
    - Recruiting
    - Barts Health
    - Principal Investigator:
      
      Mildred Iro
  - London, United Kingdom
    - Recruiting
    - Royal Free London
    - Principal Investigator:
      
      Indran Balakrishnan
  - London, United Kingdom
    - Not yet recruiting
    - Great Ormond Street
    - Principal Investigator:
      
      James Hatcher
  - London, United Kingdom
    - Recruiting
    - Guys and St Thomas'
    - Principal Investigator:
      
      Anna Goodman
  - London, United Kingdom
    - Recruiting
    - Whittington Health
    - Principal Investigator:
      
      Ana Garcia Mingo
  - Manchester, United Kingdom
    - Recruiting
    - Manchester University Hospitals
    - Principal Investigator:
      
      Mike Riste
  - Newcastle upon Tyne, United Kingdom
    - Recruiting
    - Newcastle Upon Tyne Hospitals
    - Principal Investigator:
      
      Ashley (David) Price
  - Nottingham, United Kingdom
    - Not yet recruiting
    - Nottingham University Hospitals
    - Principal Investigator:
      
      Tim Sloan
  - Oxford, United Kingdom
    - Recruiting
    - Oxford University Hospitals
    - Principal Investigator:
      
      Matthew Scarborough
  - Sheffield, United Kingdom
    - Not yet recruiting
    - Sheffield Teaching Hospitals
    - Principal Investigator:
      
      Julia Grieg
  - South Tees, United Kingdom
    - Recruiting
    - South Tees Hospitals
    - Principal Investigator:
      
      John Widdrington
  - Southampton, United Kingdom
    - Recruiting
    - University Hospital Southampton
    - Principal Investigator:
      
      Kordo Saeed
  - Stirling, United Kingdom
    - Not yet recruiting
    - NHS Forth Valley
    - Principal Investigator:
      
      Elan Tsarfati
  - Stoke, United Kingdom
    - Not yet recruiting
    - University Hospitals of North Midlands
    - Principal Investigator:
      
      Krishna Banavathi
  - Swansea, United Kingdom
    - Recruiting
    - Swansea Bay University Health Board
    - Principal Investigator:
      
      Brendan Healy
United States
- Texas
  - Houston, Texas, United States, 77030
    - Recruiting
    - Houston Methodist Research Institute
    - Contact:
      
      Cesar Arias
      
      Phone Number: 346-651-8674
      
      Email: caarias@houstonmethodist.org

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Child
Adult
Older Adult

Accepts Healthy Volunteers

Description

PLATFORM Inclusion Criteria:

Patients must fulfil all of the following criteria to be eligible to enter the SNAP trial:

Staphylococcus aureus complex grown from ≥1 blood culture
Admitted to a participating hospital at the time of eligibility assessment (OR if patient has died, they were admitted to this site anytime from the time of blood culture collection until the time of eligibility assessment)

PLATFORM 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 randomised platform (but may still participate in the registry):

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)
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.
Known previous participation in the randomised SNAP platform
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
Treating team deems enrolment in the study is not in the best interest of the patient
Treating team believes that death is imminent and inevitable
Patient is for end-of-life care and antibiotic treatment is considered not appropriate
Patient <18 years of age and paediatric recruitment not approved at recruiting site
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:

All participants that met the PLATFORM eligible are eligible to be included in this domain unless they meet any of the following exclusions listed.
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:

For PSSA silo: Index blood culture isolate is penicillin-susceptible as per the Microbiology Appendix. In short, this will require phenotypic disc testing with EUCAST (a P1 disc diffusion with zone >=26mm OR a P1 disc diffusion with zone >=26mm and the zone edge is NOT sharp) OR CLSI (a P10 disc diffusion) defined criteria.
For MSSA silo: Index blood culture isolate is methicillin-susceptible as per the Microbiology Appendix.

Note that where trial sites are not testing for penicillin-susceptibility, patients with MSSA/PRSA can be included in the MSSA silo, but those with MSSA/PSSA (but not confirmed with a P-disc) will be excluded from the backbone domain. The rationale for this is that patients with MSSA but not tested with a P-disc may be truly PSSA (with no blaZ). If the cefazolin inoculum effect (CIE) is a clinically relevant entity, then including patients with an organism without blaZ (and hence cannot have a CIE phenotype), will bias towards non-inferiority of cefazolin compared to (flu)cloxacillin.

For PSSA, the requirement for laboratories to use an accredited phenotypic test for a penicillin-susceptible phenotype, is to ensure clinical safety according to internationally accepted guidelines. The automated antimicrobial susceptibility testing, and other phenotypic tests, have poor sensitivity for detection of blaZ compared to a gold standard of blaZ PCR. Therefore, patients could be placed at risk of treatment with benzylpenicillin when the infecting isolate is actually blaZ positive, unless these guidelines are followed.

Exclusion Criteria (PSSA & MSSA):

>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)
History of type I hypersensitivity reaction (i.e. anaphylaxis or angioedema) to any penicillin or cephalosporin
History of severe delayed reaction (e.g. allergic interstitial nephritis, cutaneous vasculitis, Stevens-Johnson, DRESS, etc.) to any penicillin or cephalosporin
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.)
Treating team deems enrolment in this domain is not in the best interest of the patient
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.)
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
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

Exclusion Criteria:

Time to allocation reveal is >72 hours from time of index blood culture collection
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.
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):

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
Afebrile (<37.8°C) for the past 72 hours (at time of judging eligibility)
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)
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):

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)
Afebrile (<37.8°C) for the past 72 hours (at time of judging eligibility)
Site Principal Investigator has determined that source control is adequate

Exclusion Criteria:

When judging eligibility at platform Day 7 (+/- 2 days) and at Day 14 (+/- 2 days), exclusion criteria are:

Adherence to oral agents unlikely (as judged by site PI in consultation with the treating team)
Unreliable gastrointestinal absorption (e.g. vomiting, diarrhoea, nil by mouth, anatomical reasons)
There are no appropriate oral antibiotics due to contraindications, drug availability, or antibiotic resistance
Ongoing IV therapy unsuitable e.g. no IV access
Clinician deems not appropriate for early oral switch
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
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):

Presence of prosthetic cardiac valve, pacemaker or other intracardiac implant
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)
Intravascular/intracardiac infections (e.g. endocarditis, mycotic aneurysm)
Presence of other intracardiac abnormalities felt to put patient at increased risk of endocarditis (e.g., bicuspid aortic valve)

PET/CT DOMAIN

Inclusion Criteria:

PET/CT participating site
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.

Exclusion Criteria:

Pregnant - patients of childbearing potential should be assessed for pregnancy status and a pregnancy test performed (if not performed within the past 10 days)
Currently breastfeeding
< 18 years of age
Patient has had PET/CT in the past 7 days
Patient needs PET/CT in the next 7 days (in the opinion of the clinical team, at the time of eligibility assessment)
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)
Contraindication to PET/CT (e.g., claustrophobia, persistently elevated blood sugar levels [>12.5mmol/L] that cannot be corrected).
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
Clinician deems participation in this domain is not in the patient's best interests

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Interventional Model: Factorial Assignment
Masking: None (Open Label)

Number of Arms

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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 (β-lactam) Arm In addition to standard treatment an intravenous β-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 β-lactam). This β-lactam will be intravenous cefazolin 2g every 8 hours. For patients with renal impairment the intravenous cefazolin administration doses will be adjusted.	Drug: Cefazolin Cefazolin Drug: Vancomycin Vancomycin or Daptomycin Other Names: Daptomycin
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.	Drug: Cefazolin Cefazolin
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.	Drug: Penicillin benzylpenicillin Other Names: Benzylpenicillin Penicillin G
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.
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.	Other: Effectiveness of early switch to oral antibiotics This involves testing a strategy rather than individual antibiotic agents
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.	Drug: Clindamycin Clindamycin Other Names: Lincomycin
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.	Radiation: 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
All-cause mortality at 90 days after platform entry Time Frame: From randomisation (day 1) until day 90	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.	From randomisation (day 1) until day 90

Secondary Outcome Measures

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Melbourne

Collaborators

King's College London

Radboud University Medical Center

Rambam Health Care Campus

Sunnybrook Health Sciences Centre

UMC Utrecht

University College, London

Tan Tock Seng Hospital

McGill University Health Centre/Research Institute of the McGill University Health Centre

The Methodist Hospital Research Institute

Menzies School of Health Research

Berry Consultants

The University of Queensland

Telethon Kids Institute

Queensland University of Technology

The Peter Doherty Institute for Infection and Immunity

Aotearoa Clinical Trials

Investigators

Study Chair: Prof Steven Tong, University of Melbourne / Melbourne Health
Study Chair: Prof Joshua Davies, Menzies School of Research / Hunter New England Medical Centre

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

SNAP Trial Website

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 16, 2022

Primary Completion (Estimated)

December 1, 2028

Study Completion (Estimated)

December 1, 2028

Study Registration Dates

First Submitted

April 25, 2021

First Submitted That Met QC Criteria

November 23, 2021

First Posted (Actual)

November 30, 2021

Study Record Updates

Last Update Posted (Actual)

May 6, 2026

Last Update Submitted That Met QC Criteria

April 29, 2026

Last Verified

July 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

CT19029

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified patient data

IPD Sharing Time Frame

IPD and supporting information will be available 12 months after the publication of the primary results manuscript and will be available for a 10 year period.

IPD Sharing Access Criteria

• All requests for data sharing must be accompanied by a SNAP data access request from, a study proposal with clear statement of aims and hypotheses, and a statistical analysis plan. All applications will be assessed by the SNAP Trial Steering Committee. Applications from investigators with suitable academic capability to conduct the proposed work will be given consideration. If a proposal is approved, a signed data transfer agreement will be required before data sharing.

IPD Sharing Supporting Information Type

STUDY_PROTOCOL
SAP
ICF
ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Studies a U.S. FDA-regulated device product

product manufactured in and exported from the U.S.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Outcome Measure	Measure Description	Time Frame
Core1: All-cause mortality at 14, 28 and 42 days after platform entry Time Frame: From randomisation (day 1) until day 14, 28, and 42	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.	From randomisation (day 1) until day 14, 28, and 42
Core2: Duration of survival censored at 90 days after platform entry Time Frame: From randomisation (day 1) until day 90	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.	From randomisation (day 1) until day 90
Core3: Length of stay of acute index inpatient hospitalisation for those surviving until discharge from acute inpatient facilities (excluding HITH/COPAT/OPAT/rehab). Time Frame: From randomisation (day 1) until discharge from acute inpatient facilities, truncated at 90 days.	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.	From randomisation (day 1) until discharge from acute inpatient facilities, truncated at 90 days.
Core4: Length of stay of total index hospitalisation for those surviving until hospital discharge (including HITH/COPAT/OPAT/rehab) Time Frame: From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days	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.	From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days
Core5: Time to being discharged alive from the total index hospitalisation (including HITH/COPAT/OPAT/rehab) truncated at 90 days after platform entry Time Frame: From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days	and all deaths within 90 days will be considered '90 days'	From randomisation (day 1) to discharge from total index hospitalisation, truncated at 90 days
Core6: 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). Time Frame: From day 14 until day 90	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.	From day 14 until day 90
Core7: Diagnosis of new foci between 14 and 90 days after platform entry. Time Frame: From day 14 until day 90	The presence of new foci will be determined by the site investigator and can incorporate clinical, radiological, microbiological and pathological findings.	From day 14 until day 90
Core8: C. difficile diarrhoea as determined by a clinical laboratory in the 90 days following platform entry for participants ≥2 years of age. Time Frame: From randomisation (day 1) until day 90	This means a stool submitted to a clinical laboratory has tested positive for C. difficile toxin or toxin gene.	From randomisation (day 1) until day 90
Core9: Serious adverse reactions (SARs) in the 90 days following platform entry Time Frame: From randomisation (day 1) until day 90	SARs defined only as serious events that are attributable to one or more randomised study interventions	From randomisation (day 1) until day 90
Core10: Health economic costs as detailed in the health ecnomics appendix. Time Frame: From randomisation (day 1) until day 90	Including hospital length of stay, readmissions, and patient employment status.	From randomisation (day 1) until day 90
Core11: Proportion of participants who have returned to their usual level of function at day 90. Time Frame: From randomisation (day 1) until day 90	Determined by whether the modified functional bloodstream infection score (FBIS) remained the same or improved between baseline and 90 days after platform entry where baseline=best score within the 4 weeks prior to platform entry.	From randomisation (day 1) until day 90
Core12: Desirability of outcome ranking 1 (DOOR1; modified Antibiotic Resistance Leadership Group version) Time Frame: From randomisation (day 1) until day 90	See Core Protocol; unable to insert DOOR1 table	From randomisation (day 1) until day 90
Core13: Desirability of outcome ranking 2 (DOOR2; SNAP version) Time Frame: From randomisation (day 1) until day 90	See Core Protocol; unable to insert DOOR2 table	From randomisation (day 1) until day 90
Core14: Total number of antibiotic days (IV and/or oral/enteral) in the 90 days following platform entry. Time Frame: From randomisation (day 1) until day 90	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). 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.	From randomisation (day 1) until day 90
Core15: Days alive and free of antibiotics in the 90 days following platform entry. Time Frame: From randomisation (day 1) until day 90	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). 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.	From randomisation (day 1) until day 90

Staphylococcus Aureus Network Adaptive Platform Trial (SNAP)

Study Overview

Status

Conditions

Intervention / Treatment

Detailed Description

Study Type

Enrollment (Estimated)

Phase

Contacts and Locations

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Eligibility Criteria

Ages Eligible for Study

Accepts Healthy Volunteers

Description

Study Plan

How is the study designed?

Design Details

Number of Arms

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure

Measure Description

Time Frame

Secondary Outcome Measures

Outcome Measure

Measure Description

Time Frame

Collaborators and Investigators

Sponsor

Collaborators

Investigators

Publications and helpful links

General Publications

Helpful Links

Study record dates

Study Major Dates

Study Start (Actual)

Primary Completion (Estimated)

Study Completion (Estimated)

Study Registration Dates

First Submitted

First Submitted That Met QC Criteria

First Posted (Actual)

Study Record Updates

Last Update Posted (Actual)

Last Update Submitted That Met QC Criteria

Last Verified

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

IPD Plan Description

IPD Sharing Time Frame

IPD Sharing Access Criteria

IPD Sharing Supporting Information Type

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Studies a U.S. FDA-regulated device product

product manufactured in and exported from the U.S.

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Sponsors and Collaborators

Medical Conditions

Drug Interventions

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Conditions

Rare Diseases

Drug Interventions