Please use this identifier to cite or link to this item:
Title: Clindamycin adjunctive therapy for severe Staphylococcus aureus treatment evaluation (CASSETTE)-an open-labelled pilot randomized controlled trial.
Authors: Campbell AJ
Dotel R
Braddick M
Britton PN
Eisen DP
Francis JR
Lynar S
McMullan B
Meagher N
Nelson J
O'Sullivan MVN
Price DJ
Robinson JO
Whelan A
Tong SYC
Bowen AC
Davis JS
Citation: © The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
JAC Antimicrob Resist. 2022 Feb 17;4(1):dlac014. doi: 10.1093/jacamr/dlac014. eCollection 2022 Mar.
Abstract: BACKGROUND: Combination antibiotic therapy with an antitoxin agent, such as clindamycin, is included in some guidelines for severe, toxin-mediated Staphylococcus aureus infections. The evidence to support this practice is currently limited to in vitro, animal and observational human case-series data, with no previous randomized controlled trials (RCTs). OBJECTIVES: This pilot RCT aimed to determine the feasibility of conducting a clinical trial to examine if adjunctive clindamycin with standard therapy has greater efficacy than standard therapy alone for S. aureus infections. METHODS: We performed an investigator-initiated, open-label, multicentre, pilot RCT (ACTRN12617001416381p) in adults and children with severe S. aureus infections, randomized to standard antibiotic therapy with or without clindamycin for 7 days. RESULTS: Over 28 months, across nine sites, 127 individuals were screened and 34 randomized, including 11 children (32%). The primary outcome-number of days alive and free of systemic inflammatory response syndrome ≤14 days-was similar between groups: clindamycin (3 days [IQR 1-6]) versus standard therapy (4 days [IQR 0-8]). The 90 day mortality was 0% (0/17) in the clindamycin group versus 24% (4/17) in the standard therapy group. Secondary outcomes-microbiological relapse, treatment failure or diarrhoea-were similar between groups. CONCLUSIONS: As the first clinical trial assessing adjunctive clindamycin for S. aureus infections, this study indicates feasibility and that adults and children can be incorporated into one trial using harmonized endpoints, and there were no safety concerns. The CASSETTE trial will inform the definitive S. aureus Network Adaptive Platform (SNAP) trial, which includes an adjunctive clindamycin domain and participants with non-severe disease.
Click to open Pubmed Article:
Journal title: JAC-antimicrobial resistance
Volume: 4
Pages: dlac014
Publication Date: 2022-02-17
Type: Journal Article
DOI: 10.1093/jacamr/dlac014
Orcid: 0000-0002-1368-8356
Appears in Collections:(a) NT Health Research Collection

Files in This Item:
There are no files associated with this item.

Items in ePublications are protected by copyright, with all rights reserved, unless otherwise indicated.

Google Media

Google ScholarTM

Who's citing


PubMed References

Who's citing