UCLH has recruited the first UK patient to a global trial looking at the best way to treat bloodstream infections caused by staph infection.
Bloodstream infection following staph infection is common – affecting around 13,000 people in the UK every year – and is serious, with a mortality rate of around 10-15%.
The SNAP trial, involved researchers supported by the National Institute for Health and Care Research BRC at UCLH, started in Australia and is now expanding globally. It is the largest trial ever conducted looking at ways to treat the bloodstream infection. The MRC Clinical Trials Unit leads on trial management and statistical analysis within the UK and UCL is the trial's UK sponsor.
The bacteria which causes staph infection, Staphylococcus aureus, normally lives harmlessly on the skin or in the nose. But if the bacteria enter the blood through a cut or sore, they can multiply and cause a bloodstream infection – sometimes called bacteraemia. This can be very serious or even life-threatening. The infection can affect many parts of the body including the lungs, heart, bones and muscles.
S. aureus bloodstream infections are common, and many different antibiotics can be used to treat them effectively. However, researchers and clinicians are unsure which of these treatments is best.
SNAP will evaluate a range of different antibiotic treatments for three different types of S. aureus infection (penicillin-susceptible, methicillin susceptible and methicillin-resistant). The innovative way the study is designed means that it allows for simultaneous evaluation of multiple interventions.
Trial participants are being randomly allocated to receive one of two possible ‘backbone’ antibiotics for each type of S. aureus infection.
Participants will then be randomly allocated to receive either clindamycin (a medicine which prevents S. aureus from producing toxins that damage the body) in addition to a backbone antibiotic, or a backbone antibiotic only with no clindamycin.
All participants begin their antibiotic course intravenously. After seven days, those who are improving quickly are randomly allocated to either continue the course intravenously or switch to an oral antibiotic. Those who are not well enough after seven days will continue taking antibiotics intravenously until day 14, where, if their condition has improved, they will be randomised to either stay on intravenous treatment or switch to oral antibiotics.
SNAP is funded by the National Institute for Health and Care Research and is expected to run until 2027.
Further information: visit the SNAP website and view patients videos about SNAP.
Image: members of the SNAP trial team: Michelle Berkeley, Michael Marks, Florence Taylor and Rubin Rose-Key.
