Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
PHASE4
8000 participants
INTERVENTIONAL
2022-02-16
2028-12-01
Brief Summary
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Detailed Description
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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.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
TREATMENT
NONE
Study Groups
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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.
No interventions assigned to this group
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.
Cefazolin
Cefazolin
Vancomycin
Vancomycin or Daptomycin
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.
No interventions assigned to this group
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.
Cefazolin
Cefazolin
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.
No interventions assigned to this group
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.
Penicillin
benzylpenicillin
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 interventions assigned to this group
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.
Clindamycin
Clindamycin
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.
No interventions assigned to this group
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.
Effectiveness of early switch to oral antibiotics
This involves testing a strategy rather than individual antibiotic agents
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.
No interventions assigned to this group
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.
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.
Interventions
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Cefazolin
Cefazolin
Penicillin
benzylpenicillin
Clindamycin
Clindamycin
Vancomycin
Vancomycin or Daptomycin
Effectiveness of early switch to oral antibiotics
This involves testing a strategy rather than individual antibiotic agents
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.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
1. Staphylococcus aureus complex grown from ≥1 blood culture
2. 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)
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.
1. 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.
2. 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.
1\. MRSA confirmed microbiologically
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
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.
Exclusion Criteria
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
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)
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
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)
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\. 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
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
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
ALL
No
Sponsors
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Berry Consultants
OTHER
McGill University Health Centre/Research Institute of the McGill University Health Centre
OTHER
Menzies School of Health Research
OTHER
Aotearoa Clinical Trials
UNKNOWN
Queensland University of Technology
OTHER
Sunnybrook Health Sciences Centre
OTHER
Tan Tock Seng Hospital
OTHER
Telethon Kids Institute
OTHER
The Peter Doherty Institute for Infection and Immunity
OTHER
The University of Queensland
OTHER
UMC Utrecht
OTHER
Radboud University Medical Center
OTHER
King's College London
OTHER
Rambam Health Care Campus
OTHER
University College, London
OTHER
The Methodist Hospital Research Institute
OTHER
University of Melbourne
OTHER
Responsible Party
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Principal Investigators
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Prof Steven Tong
Role: STUDY_CHAIR
University of Melbourne / Melbourne Health
Prof Joshua Davies
Role: STUDY_CHAIR
Menzies School of Research / Hunter New England Medical Centre
Locations
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Houston Methodist Research Institute
Houston, Texas, United States
Canberra Hospital
Garran, Australia Capital Territory, Australia
Blacktown Hospital
Blacktown, New South Wales, Australia
Royal Prince Alfred Hospital
Camperdown, New South Wales, Australia
Concord Repatriation and General Hospital
Concord, New South Wales, Australia
St Vincent's Hospital Sydney
Darlinghurst, New South Wales, Australia
Nepean Hospital
Kingswood, New South Wales, Australia
St George Hospital
Kogarah, New South Wales, Australia
Liverpool Hospital
Liverpool, New South Wales, Australia
John Hunter Hospital
New Lambton Heights, New South Wales, Australia
John Hunter Children's Hospital
Newcastle, New South Wales, Australia
Orange Health Service
Orange, New South Wales, Australia
Prince of Wales Hospital
Randwick, New South Wales, Australia
Sydney Children's Hospital
Randwick, New South Wales, Australia
The Children's Hospital at Westmead
Westmead, New South Wales, Australia
Westmead Hospital
Westmead, New South Wales, Australia
Wollongong Hospital
Wollongong, New South Wales, Australia
Royal Darwin Hospital
Tiwi, Northern Territory, Australia
Sunshine Coast University Hospital
Birtinya, Queensland, Australia
Cairns Hospital
Cairns, Queensland, Australia
Royal Brisbane and Women's Hospital
Herston, Queensland, Australia
Ipswich Hospital
Ipswich, Queensland, Australia
Logan Hospital
Meadowbrook, Queensland, Australia
Redcliffe Hospital
Redcliffe, Queensland, Australia
Robina Hospital
Robina, Queensland, Australia
Queensland Children's Hospital
South Brisbane, Queensland, Australia
Gold Coast University Hospital
Southport, Queensland, Australia
Princess Alexandra Hospital
Woolloongabba, Queensland, Australia
Lyell McEwin Hospital
Adelaide, South Australia, Australia
Flinders Medical Centre
Bedford Park, South Australia, Australia
Women and Children's Hospital
North Adelaide, South Australia, Australia
Women's and Children's Hospital
North Adelaide, South Australia, Australia
Royal Hobart Hospital
Hobart, Tasmania, Australia
Launceston Hospital
Launceston, Tasmania, Australia
Grampians Health
Ballarat, Victoria, Australia
Bendigo Health
Bendigo, Victoria, Australia
Box Hill Hospital
Box Hill, Victoria, Australia
Monash Children's Hospital
Clayton, Victoria, Australia
Monash Health - Monash Medical Centre & Jesse McPherson Private Hospital
Clayton, Victoria, Australia
Western Health - Footscray, Joan Kirner & Sunshine Hospitals
Footscray, Victoria, Australia
Frankston Hospital
Frankston, Victoria, Australia
Barwon Health - University Hospital Geelong
Geelong, Victoria, Australia
Austin Hospital
Heidelberg, Victoria, Australia
Alfred Hospital
Melbourne, Victoria, Australia
Royal Melbourne Hospital
Parkville, Victoria, Australia
Royal Children's Hospital Melbourne
Parkville, Victoria, Australia
Goulburn Valley Health
Shepparton, Victoria, Australia
La Trobe Regional Hospital
Traralgon, Victoria, Australia
Fiona Stanley Hospital
Murdoch, Western Australia, Australia
Perth Children's Hospital
Nedlands, Western Australia, Australia
Royal Perth Hospital
Perth, Western Australia, Australia
Armadale Hospital
Perth, Western Australia, Australia
Peter Lougheed Centre
Calgary, Alberta, Canada
Foothills Medical Center
Calgary, Alberta, Canada
Rockyview Hospital
Calgary, Alberta, Canada
South Health Campus
Calgary, Alberta, Canada
University of Alberta Hospital
Edmonton, Alberta, Canada
Richmond Hospital
Richmond, British Columbia, Canada
Fraser Health Authority - Surrey Memorial Hospital
Surrey, British Columbia, Canada
Vancouver General Hospital
Vancouver, British Columbia, Canada
St. Boniface Hospital
Winnipeg, Manitoba, Canada
Health Sciences Centre Winnipeg
Winnipeg, Manitoba, Canada
Grace Hospital
Winnipeg, Manitoba, Canada
Eastern Health - Health Sciences Centre (Memorial University)
St. John's, Newfoundland and Labrador, Canada
Eastern Regional Health Authority - St. Clare's Mercy Hospital
St. John's, Newfoundland and Labrador, Canada
Toronto East Health Network - Michael Garron Hospital
East York, Ontario, Canada
University Health Network - Toronto General Hospital
East York, Ontario, Canada
Hamilton Health Sciences - Hamilton General Hospital
Hamilton, Ontario, Canada
Hamilton Health Sciences - Juravinski Hospital
Hamilton, Ontario, Canada
Kingston Health Sciences Centre - Kingston General Hospital
Kingston, Ontario, Canada
London Health Sciences Centre - University Hospital, LHSC
London, Ontario, Canada
Niagara Health - Niagara Falls Site
Niagara Falls, Ontario, Canada
The Ottawa Hospital - Civic Campus
Ottawa, Ontario, Canada
The Ottawa Hospital - General Campus
Ottawa, Ontario, Canada
Sault Area Hospital
Sault Ste. Marie, Ontario, Canada
Niagara Health - St. Catharines Site
St. Catharines, Ontario, Canada
Unity Health - St Michael's Hospital
Toronto, Ontario, Canada
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Sinai Heath System - Mount Sinai Hospital
Toronto, Ontario, Canada
Unity Health Toronto - St Joseph's Health Centre
Toronto, Ontario, Canada
University Health Network - Toronto Western Hospital
Toronto, Ontario, Canada
CISSS - Hôpital Cité-de-la-Santé Hospital
Laval, Quebec, Canada
Jewish General Hospital
Montreal, Quebec, Canada
McGill University Health Centre - Montral General Hospital
Montreal, Quebec, Canada
McGill University Health Centre - Montreal Children's Hospital
Montreal, Quebec, Canada
McGill University Health Centre - Royal Victoria Hospital
Montreal, Quebec, Canada
Hôpital Régional de Saint Jérôme
Saint-Jérôme, Quebec, Canada
University of Sherbrooke Health Centre - Hospital Fleurimont
Sherbrooke, Quebec, Canada
University of Sherbrooke Health Centre - Hotel Dieu
Sherbrooke, Quebec, Canada
Rambam Health Care Campus
Haifa, Haifa District, Israel
Beilinson Hospital
Petah Tikva, Petah Tikva, Israel
Schneider Hospital
Petah Tikva, , Israel
Sheba Medical Centre
Ramat Gan, , Israel
Science Tokyo University Hospital
Ichikawa, Chiba, Japan
Jeroen Bosch Hospital
's-Hertogenbosch, , Netherlands
UMC Groningen
Groningen, , Netherlands
Antonius Ziekenhuis
Nieuwegein, , Netherlands
Radboud University Medical Center
Nijmegen, , Netherlands
Ikazia Ziekenhuis
Rotterdam, , Netherlands
University Medical Center Utrecht
Utrecht, , Netherlands
Auckland City Hospital
Grafton, Auckland, New Zealand
Middlemore Hospital
Otahuhu, Auckland, New Zealand
North Shore Hospital
Takapuna, Auckland, New Zealand
Christchurch Hospital
Christchurch, Canterbury, New Zealand
Waikato Hospital
Hamilton, Hamilton, New Zealand
Hutt Valley Hospital
Boulcott, Lower Hutt, New Zealand
Tauranga Hospital
Tauranga, Tauranga, New Zealand
Wellington Hospital
Newtown, Wellington Region, New Zealand
Whangarei Hospital
Whangarei, Whangarei, New Zealand
Starship Hospital
Auckland, , New Zealand
KidzFirst
Auckland, , New Zealand
National University Hospital
Singapore, Singapore, Singapore
Singapore General Hospital
Singapore, Singapore, Singapore
Tan Tock Seng Hospital
Singapore, Singapore, Singapore
Charlotte Maxeke Johannesburg Academic Hospital
Johannesburg, , South Africa
Helen Joseph Hospital
Johannesburg, , South Africa
Rahima Moosa Mother and Child Hospital
Johannesburg, , South Africa
NHS Grampian
Aberdeen, , United Kingdom
University Hospitals Birmingham
Birmingham, , United Kingdom
Brighton and Sussex University Hospitals
Brighton, , United Kingdom
North Bristol
Bristol, , United Kingdom
University Hospitals Bristol and Weston
Bristol, , United Kingdom
Cambridge University Hospitals
Cambridge, , United Kingdom
Cardiff and Vale University
Cardiff, , United Kingdom
Royal Cornwall Hospitals
Cornwall, , United Kingdom
Royal Devon University Healthcare
Devon, , United Kingdom
NHS Tayside
Dundee, , United Kingdom
Lothian Western General
Edinburgh, , United Kingdom
Greater Glasgow and Clyde
Glasgow, , United Kingdom
NHS Golden Jubilee
Glasgow, , United Kingdom
Hull University Teaching Hospitals
Hull, , United Kingdom
Leeds Teaching Hospitals
Leeds, , United Kingdom
Liverpool University Hospital
Liverpool, , United Kingdom
Barts Health
London, , United Kingdom
Great Ormond Street
London, , United Kingdom
Guys and St Thomas'
London, , United Kingdom
Imperial College Healthcare
London, , United Kingdom
Kings College Hospital
London, , United Kingdom
Royal Free London
London, , United Kingdom
University College London Hospitals
London, , United Kingdom
Whittington Health
London, , United Kingdom
Manchester University Hospitals
Manchester, , United Kingdom
Newcastle Upon Tyne Hospitals
Newcastle upon Tyne, , United Kingdom
Nottingham University Hospitals
Nottingham, , United Kingdom
Oxford University Hospitals
Oxford, , United Kingdom
Sheffield Teaching Hospitals
Sheffield, , United Kingdom
South Tees Hospitals
South Tees, , United Kingdom
University Hospital Southampton
Southampton, , United Kingdom
NHS Forth Valley
Stirling, , United Kingdom
University Hospitals of North Midlands
Stoke, , United Kingdom
Swansea Bay University Health Board
Swansea, , United Kingdom
Countries
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Central Contacts
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Facility Contacts
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James McMahon
Role: primary
Principal Investigator Yoshiaki Gu
Role: primary
References
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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.
Sakai K, Homma H, Lee JA, Fukushima T, Santa T, Tashiro K, Iwatsubo T, Imai K. Emergence of D-aspartic acid in the differentiating neurons of the rat central nervous system. Brain Res. 1998 Oct 12;808(1):65-71. doi: 10.1016/s0006-8993(98)00599-x.
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SNAP Trial Website
Other Identifiers
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CT19029
Identifier Type: -
Identifier Source: org_study_id
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