Articles producció científica> Medicina i Cirurgia

Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: study protocol for the SAFO t

  • Identification data

    Identifier: imarina:9267385
  • Authors:

    Grillo, Sara
    Cuervo, Guillermo
    Carratala, Jordi
    San-Juan, Rafael
    Aguado, Jose M.
    Morata, Laura
    Gomez-Zorrilla, Silvia
    Lopez-Contreras, Joaquin
    Gasch, Oriol
    Gomila-Grange, Aina
    Iftimie, Simona
    Garcia-Pardo, Graciano
    Calbo, Esther
    Boix-Palop, Lucia
    Orio, Isabel
    Jover-Saenz, Alfredo
    Eduardo Lopez-Cortes, Luis
    Euba, Gorane
    Aguirregabiria, Malen
    Jose Garcia-pais, Maria
    Gioia, Francesca
    Ramon Pano, Jose
    Luisa Pedro-Botet, Maria
    Maria Benitez, Rosa
    Teresa Perez-Rodriguez, Maria
    Meije, Yolanda
    Belen Loeches-Yague, Maria
    Horna, Gertrudis
    Berbel, Damaris
    Angeles Dominguez, Maria
    Padulles, Ariadna
    Cobo, Sara
    Hereu, Pilar
    Videla, Sebastian
    Tebe, Cristian
    Pallares, Natalia
    Miro, Josep M.
    Pujol, Miquel
    Safo Study Grp
    Spanish Network Res Infect Dis
    Bmj Open
    10.1136/bmjopen-2021-051208
    Bmj Open. 11 (8): e051208-
  • Others:

    Author, as appears in the article.: Grillo, Sara; Cuervo, Guillermo; Carratala, Jordi; San-Juan, Rafael; Aguado, Jose M.; Morata, Laura; Gomez-Zorrilla, Silvia; Lopez-Contreras, Joaquin; Gasch, Oriol; Gomila-Grange, Aina; Iftimie, Simona; Garcia-Pardo, Graciano; Calbo, Esther; Boix-Palop, Lucia; Orio, Isabel; Jover-Saenz, Alfredo; Eduardo Lopez-Cortes, Luis; Euba, Gorane; Aguirregabiria, Malen; Jose Garcia-pais, Maria; Gioia, Francesca; Ramon Pano, Jose; Luisa Pedro-Botet, Maria; Maria Benitez, Rosa; Teresa Perez-Rodriguez, Maria; Meije, Yolanda; Belen Loeches-Yague, Maria; Horna, Gertrudis; Berbel, Damaris; Angeles Dominguez, Maria; Padulles, Ariadna; Cobo, Sara; Hereu, Pilar; Videla, Sebastian; Tebe, Cristian; Pallares, Natalia; Miro, Josep M.; Pujol, Miquel;Safo Study Grp; Spanish Network Res Infect Dis
    Department: Medicina i Cirurgia
    URV's Author/s: Garcia Pardo, Graciano / Iftimie Iftimie, Simona Mihaela / TEBÉ CORDOMÍ, CRISTIAN
    Keywords: Mortality Microbiology Infectious diseases Endocarditis Clinical trials
    Abstract: Introduction Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia.Methods We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (>= 18 years) with isolation of MSSA from at least one blood culture <= 72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant).Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders.
    Thematic Areas: Saúde coletiva Psicología Odontología Nutrição Medicine, general & internal Medicine (miscellaneous) Medicine (all) Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Farmacia Ensino Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Ciência da computação Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: graciano.garcia@urv.cat simonamihaela.iftime@urv.cat
    Author identifier: 0000-0003-0714-8414
    Record's date: 2024-07-20
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://bmjopen.bmj.com/content/11/8/e051208.long
    Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Bmj Open. 11 (8): e051208-
    APA: Grillo, Sara; Cuervo, Guillermo; Carratala, Jordi; San-Juan, Rafael; Aguado, Jose M.; Morata, Laura; Gomez-Zorrilla, Silvia; Lopez-Contreras, Joaquin; (2021). Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: study protocol for the SAFO trial. Bmj Open, 11(8), e051208-. DOI: 10.1136/bmjopen-2021-051208
    Article's DOI: 10.1136/bmjopen-2021-051208
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Medicine, General & Internal
    Mortality
    Microbiology
    Infectious diseases
    Endocarditis
    Clinical trials
    Saúde coletiva
    Psicología
    Odontología
    Nutrição
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    General medicine
    Farmacia
    Ensino
    Enfermagem
    Educação física
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciências ambientais
    Ciência da computação
    Biotecnología
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