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NCT07376889PHASE4Recruiting

Combination Antibiotic Therapy for Staphylococcus Aureus Bacteremia

Intermountain Health Care, Inc.

Start Date

2/1/2026

Completion Date

1/1/2029

Summary

The purpose of this study is to see if, in selected patients with a serious bacterial infection of the bloodstream, treating the bacterial infection with a combination of antibiotics is more effective than treating the infection with a single antibiotic. Participants must have blood cultures which are positive for a certain type of bacteria.

Detailed Description

Staphyloccocus aureus bacteremia (SAB) is a common infectious disease condition in hospitalized patients which is associated with significant morbidity, excessive costs, and high mortality, despite effective antibiotic therapy. This pragmatic study is designed to test the hypothesis that outcomes in adults hospitalized with SAB will be improved by using combination antibiotic therapy (CAT) as early, targeted therapy in a high-risk subgroup. A group of patients identified early in their course as meeting at least one high-risk criterion who have no contraindications will be treated with one of two antibiotic strategies commonly used within usual care, namely: 1) antibiotic monotherapy or 2) combination antibiotic therapy, depending on the random assignment for each hospital, each month. Low-risk patients will be treated per usual care. Data from all patients admitted to participating hospitals with SAB will be included in the analysis.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Age ≥18 years * Alive and admitted to an Intermountain Health (IH) hospital acute care unit at enrollment * Initial positive blood culture with either methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA), collected: 1. on or during the index admission to an IH hospital, or 2. in an ambulatory setting (laboratory, clinic or emergency department) within 48 hours of the index admission, or 3. at a non-IH network hospital within 24 hours of subsequent transfer to an IH hospital Exclusion Criteria: * Patient requests that patient health data not be included in the analysis

Interventions

DRUG

Antibiotic Monotherapy (AM) for patients with methicillin-sensitive S. aureus bacteremia (MSSAB)

DRUG

Antibiotic Monotherapy (AM) for patients with methicillin-resistant S. aureus bacteremia (MRSAB)

DRUG

Combination Antibiotic Therapy (CAT) for patients with methicillin-sensitive S. aureus bacteremia (MSSAB)

DRUG

Combination Antibiotic Therapy (CAT) for patients with methicillin-resistant S. aureus bacteremia (MRSAB)

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Conditions

Staphylococcus Aureus Bacteremia

Locations

Platte Valley Hospital

Brighton, Colorado 80601

United States

Saint Joseph Hospital

Denver, Colorado 80218

United States

St. Mary's Regional Hospital

Grand Junction, Colorado 81501

United States

Good Samaritan Hospital

Lafayette, Colorado 80026

United States

Lutheran Medical Center

Wheat Ridge, Colorado 80401

United States

St. Vincent Regional Hospital

Billings, Montana 59101

United States

St. James Hospital

Butte, Montana 59701

United States

Holy Rosary Hospital

Miles City, Montana 59301

United States

Intermountain Medical Center

Murray, Utah 84107

United States

McKay-Dee Hospital

Ogden, Utah 84403

United States

Utah Valley Hospital

Provo, Utah 84604

United States

LDS Hospital

Salt Lake City, Utah 84143

United States

St. George Regional Hospital

St. George, Utah 84790

United States