Daptomycin vs. Vancomycin for the Treatment of Methicillin Resistant S. Aureus Bacteremia (DAPTO-SNAP)

May 22, 2026 updated by: Todd C. Lee MD MPH FIDSA

DAPTO-SNAP: Daptomycin vs. Vancomycin for the Treatment of Methicillin Resistant S. Aureus Bacteremia

This is an open label randomized controlled trial for patients with methicillin resistant S. aureus (MRSA) bloodstream infection which will directly compare the two most commonly used therapies, vancomycin and daptomycin.

This study is an approved sub-study of The Staphylococcus aureus Network Adaptive Platform (SNAP) trial (NCT05137119)

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

300

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

Study Locations

  • Australia
    • New South Wales
      • Concord, New South Wales, Australia, 2139
        • Recruiting
        • Concord Repatriation and General Hospital
        • Principal Investigator:
          • Genevieve McKew
        • Contact:
      • Newcastle, New South Wales, Australia, 2305
      • Westmead, New South Wales, Australia, 2145
    • Queensland
      • Herston, Queensland, Australia, 4029
    • South Australia
      • Bedford Park, South Australia, Australia, 5042
        • Recruiting
        • Flinders Medical Centre
        • Contact:
        • Principal Investigator:
          • Nicholas Anagnostou, MD
    • Victoria
      • Box Hill, Victoria, Australia, 3128
      • Clayton, Victoria, Australia, 3168
        • Recruiting
        • Monash Medical Campus (Monash Medical Centre + Jesse McPherson Private Hospital)
        • Contact:
        • Principal Investigator:
          • Ben Rogers, MD PhD
      • Parkville, Victoria, Australia, 3050
        • Recruiting
        • Royal Melbourne Hospital
        • Contact:
        • Principal Investigator:
          • Justin Denholm, MD
    • Western Australia
      • Murdoch, Western Australia, Australia, 6150
      • Perth, Western Australia, Australia, 6000
  • Canada
    • Alberta
      • Edmonton, Alberta, Canada
        • Recruiting
        • University of Alberta Hospital
        • Principal Investigator:
          • Stephanie Smith, MD
        • Contact:
    • British Columbia
      • Surrey, British Columbia, Canada, V3V1Z2
        • Recruiting
        • Fraser Health Authority (Surrey Memorial Hospital)
        • Principal Investigator:
          • Kevin Afra, MD
        • Contact:
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada
        • Recruiting
        • Newfoundland Health Services (Health Sciences Centre and St. Clare's Mercy Hospital)
        • Contact:
        • Principal Investigator:
          • Peter Daly, MD
    • Ontario
      • Hamilton, Ontario, Canada, L8L 2X2
        • Recruiting
        • Hamilton Health Sciences (Hamilton General Hospital and Juravinski Hospital)
        • Principal Investigator:
          • Dominik Mertz, MD
        • Contact:
    • Quebec
      • Montreal, Quebec, Canada, H3T 1E2
        • Recruiting
        • Jewish General Hospital
        • Contact:
        • Principal Investigator:
          • Leighanne Parkes, MD
      • Montreal, Quebec, Canada, H4A3S1
        • Recruiting
        • McGill University Health Centre (Royal Victoria Hospital and Montreal General Hospital)
        • Principal Investigator:
          • Emily G McDonald, MD MSc
        • Principal Investigator:
          • Todd C Lee, MD MPH FIDSA
        • Contact:
        • Sub-Investigator:
          • Matthew P. Cheng, MD SM

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

The participant must meet all inclusion and exclusion criteria for the SNAP Platform (NCT05137119) and also the following inclusion and exclusion criteria:

Inclusion Criteria:

  • Methicillin-resistant S. aureus bacteremia

Exclusion Criteria:

  • Severe allergy or non-severe rash to vancomycin or daptomycin
  • Suspected or confirmed MRSA pneumonia
  • Known vancomycin minimum inhibitory concentration (MIC) greater than or equal to 2mg/L or daptomycin MIC greater than or equal to 1mg/L

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: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Daptomycin
Daptomycin given by injection at a dose determined by the treating clinicians but no less than 6mg/kg
Drug: Daptomycin for Injection
Daptomycin given by injection at a dose determined by the treating team but not to be less than 6mg/kg
Active Comparator: Vancomycin
Vancomycin given by injection at a dose determined by the treating clinicians to achieve a trough-based or AUC-based target
Drug: Vancomycin (IV)
Vancomycin by injection to be given at a dose selected by the treating team to achieve a desired trough level or AUC-based target, as determined by local standards of care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Desirability of Outcome Ranking (DOOR)
Time Frame: Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)

Desirability of Outcome Ranking (DOOR) - an ordinal outcome with 5 levels defined:

Rank 1 - Alive without complication Rank 2 - Alive with 1 complication Rank 3 - Alive with 2 complications Rank 4 - Alive with 3 complications Rank 5 - Dead

Complications include:

  1. Clinical failure: Absence of resolution of clinical signs and symptoms of S. aureus bacteremia such that no additional antibiotic therapy is required or anticipated.
  2. Infectious Complications: Including new endocarditis; new evidence of other deep metastatic foci (e.g., osteomyelitis or deep abscess); relapse of MRSA bacteremia after a patient has sterilized their initial blood cultures; readmission for subsequent care of S. aureus bacteremia; need for unplanned source control procedures; change of therapy due to inadequate clinical response.
  3. Serious adverse drug event (Common Terminology Criteria class 4) due to study drug OR adverse drug event (classes 1-3) leading to discontinuation of the study drug
Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical failure
Time Frame: Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Defined as the absence of resolution of clinical signs and symptoms of S. aureus bacteremia such that no additional antibiotic therapy is required or anticipated for its treatment.
Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Serious Adverse Event or Adverse Event Leading to Discontinuation
Time Frame: Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Defined as a serious adverse drug event (Common Terminology Criteria for Adverse Events (CTCAE) class 4) presumed due to study drug OR adverse drug event (CTCAE classes 1-3) leading to discontinuation of the study drug
Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
All cause mortality
Time Frame: Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Death from any cause
Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Infectious Complications
Time Frame: Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)

Defined as change in therapy for inadequate clinical response; new endocarditis; new evidence of other deep metastatic foci (e.g., osteomyelitis or deep abscess); relapse of MRSA bacteremia after a patient has sterilized their initial blood cultures; readmission for subsequent care of S. aureus bacteremia; need for unplanned source control procedures; change of antibiotic therapy due to inadequate clinical response.

New implies that the complication was not suspected at enrollment and is not a function of delay to diagnostic testing.
Day 90 post enrollment in the S. aureus Network Adaptive Platform Trial (NCT05137119)
Drug Induced Myostitis
Time Frame: Occurring while on therapy up to day 42 from enrollment in SNAP (NCT05137119)
Defined as a creatinine kinase level greater than or equal to 5 times the upper limit of normal
Occurring while on therapy up to day 42 from enrollment in SNAP (NCT05137119)
Eosinophilic pneumonia
Time Frame: Occurring while on therapy up to day 42 from enrollment in SNAP (NCT05137119)
Defined as the development of symptomatic eosinophilic pneumonia as diagnosed by the treating team in consultation with the appropriate specialists
Occurring while on therapy up to day 42 from enrollment in SNAP (NCT05137119)

Collaborators and Investigators

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

Sponsor

Todd C. Lee MD MPH FIDSA

Collaborators

University of Melbourne
The Peter Doherty Institute for Infection and Immunity

Investigators

  • Principal Investigator: Todd C Lee, MD MPH FIDSA, McGill University Health Centre/Research Institute of the McGill University Health 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

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)

November 14, 2024

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

November 1, 2027

Study Registration Dates

First Submitted

October 9, 2024

First Submitted That Met QC Criteria

October 9, 2024

First Posted (Actual)

October 15, 2024

Study Record Updates

Last Update Posted (Actual)

May 26, 2026

Last Update Submitted That Met QC Criteria

May 22, 2026

Last Verified

August 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025-10666
  • 466322 (Other Grant/Funding Number: Canadian Institutes of Health Research)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Data sharing policies are dependent on the policies of the SNAP Platform (NCT05137119)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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