Grant: Project Grant

S. aureus bacteremia is a leading bacterial cause of global mortality overall. There are an estimated 10,000 to 15,000 episodes per year in Canada resulting in 2,000-3000 deaths. Interventions which reduce morbidity and mortality are urgently needed. The S. aureus Network Adaptive Platform (SNAP) is an internationally funded series of clinical trials ongoing in several countries (Australia, Canada, Israel, New Zealand, Singapore, and the UK). We will use this platform to test whether a patient who develops S. aureus bacteremia while taking aspirin is better to continue aspirin or change to another drug called clopidogrel that can replace aspirin for preventing cardiac and vascular events but also appears to have anti-Staphylococcus activity. By testing patients who already need to be taking aspirin, we minimize any risk of bleeding, while also being able to test the hypothesis that clopidogrel is a potential therapy in patients with S. aureus bacteremia. Across more than 50 sites worldwide, we plan to recruit approximately 300 patients (150 to each therapy) and compare the outcome which includes death, treatment failure (the patient is alive but the bacteria later comes back in the blood or somewhere else), and drug side effects like bleeding or cardiovascular events.