Safe shortening of antibiotic treatment duration for complicated Staphylococcus aureus bacteremia (SAFE-trial)

You may be able to join if

• Adults with methicillin-sensitive complicated SAB, defined as having at least one blood culture positive for S. aureus and one of the following conditions:
• Evidence of organ involvement and/or deep-seated infection. Examples of clinical diagnoses are: endocarditis, spondylodiscitis, arthritis, intravascular infection, abscess, and/or metastatic complications.
• Predictors of complicated SAB, defined as presence of at least one of the following risk factors for complicated SAB: a. community acquisition; b. delay > 48 hours of adequate treatment after the initial positive blood culture; c. positive follow-up blood culture > 48 hours after initiation of adequate treatment; d. persistence of fever at 72 hours after the initial positive blood culture (temperature > 38 degrees for two consecutive calendar days, measured at two time points with at least 24 hours interval, between 2 days and 7 days after the initial positive blood culture) e.unknown primary source of infection (porte d’entrée).
• 1) Satisfactory clinical response to initial treatment, defined as meeting all of the following: a) Negative blood culture for S. aureus on day 8 of adequate antibiotic treatment, defined as intravenous administration of an antibiotic agent with in-vitro activity against the cultured S. aureus. In absence of blood culture sampling on day 8, the date of first negative blood culture is the midpoint between the last positive blood culture for S. aureus and the first negative blood culture for S. aureus. b) Negative intra-operative cultures in patients with S. aureus native valve endocarditis who underwent cardiac surgery. c) C-reactive protein (CRP) decline to at least 50% below peak level or to <30 mg/L within 14 days of adequate antibiotic treatment. A high CRP due to an evident other cause, for example, an unrelated infection, is disregarded in this definition. d) Absence of fever (temperature < 38 degrees for two consecutive calendar days, measured at two time points with at least 24 hours interval) between 7 and 14 days of adequate antibiotic treatment. Fever due to unrelated, intercurrent infection (e.g. respiratory tract infection) is disregarded in this definition.